In his regular WSJ column, family physician Ben Brewer laments the lack of compassion and empathy in the medical profession:
Somewhere along the line too many doctors stopped being healers and became prescribers and technicians.We became business people and started thinking in terms of relative value units — the coin of the medical finance realm — as much as how to make patients better. We took seminars in medical coding, so we could talk the same lingo as the government and the insurance companies.
The changes in medicine are at odds with many of the values that defined the profession I joined.
I’ve only been in practice for 6+ years, so the current business-skewed view is the only world I know.
The only exposure I get of what medicine “used to be” are through columns like Dr. Brewer’s, and I have to say, it’s shocking to read how far the medical profession has fallen.
I can’t imagine living through it.
topics: doctors, compassion
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{ 5 comments }
It’s sad isn’t it?
It isn’t just nostaligia. I have been around much longer, and the loss of professionalism is shocking. Doctors are just people too. They are not angels but were able to pretend to be as long as society helped hold them on the angel pedestal. They feel that the contract was broken and society let them down. They have also been severely corrupted by third party payment as have been the public.
Every prediction that the AMA made in opposing Medicare has come true. They knew that it would undermine the ethics and professionalism of doctors in time. Frederick Hayek showed us 60 years ago how letting a bureaucracy take over an area of economy actually ends up driving personal virtue out of those affected (”The Road to Serfdom”)
A physician’s ethical obligations are defined by the existence of a patient (”suffering one”)– who for thousands of years came to the physician from that perspective and sought succor on that basis. Insurance and medicare, 60’s anti-authoritarianism, and government bureaucracy transformed patients into customers who come seeking the fullfillment of an entitlement.
What ethical obligation do you have to a customer other than to not lie to them and to keep your promises? Certainly not to care about them or to put their interests before your own?
The personal element will return to the doctor-patient relationship when it is defined personally and not bureaucratically and contractually.
Regarding the comments made by anon 9:51 — I’d counter that the more distance you place between yourself and your patient, the easier it becomes for you to lie and to break promises. That is not good.
Having witnessed first-hand how far a clinic-employed risk management JD will go — lies, accusations deliberately crafted so broad that they make defending one’s self impossible, descriptions of events wildly distorted and then placed into the record as “facts” — to destroy a perceived threat where none actually exists, I think the greater and most immediate burden rests on the (bureaucratic/administrative side of) medical businesses to shape up and regain some honor and humanity.
Perhaps then the doctors they employ will encounter less of that “entitlement” attitude, whatever that is. Maybe it’s just patients trying to protect themselves from harm.
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