Our country fails to view physicians as humans

As a patient, and reader of KevinMD.com, I’d like to respond to a recent piece, Doctors face difficult choices to save Medicare.

The funny thing about this entire situation is that people refer to numbers. Numbers that consist of how much doctors are in debt when actually entering into the working world, how much Medicare reimburses or pays annually, how many patients are actually on Medicare, and how much in debt our country truly is. The bottom line is that these physicians are the soul of our country.

These are the men and women in this country that spend years in school learning how to save lives and take care of some of the most unruly and agonizing patients in the world. Our country fails to view these physicians as people as well. We expect these men and women to work around the clock to take care of us, individually, with patience, understanding, and knowledge. Expertise in their field that is questioned every day – questioned and denied by insurance companies that believe that they have a say in what medication is necessary for patients. Insurance companies that have now been given the power to make decisions for patients with absolutely no medical knowledge or background, but simply based off of a number step-edit system.

These doctors, these physicians, these people, have families that they rarely see. Have lives that they are barely able to live because despite what our country may believe, these men and women have now been forced to work around the clock simply to make a living that merely pays off what they initially set out to do. These people essentially give their lives away to the number of patients demanding instant results and instantaneous fixes to health problems related to their own decisions and the ways in which they have chosen to live. Regardless of the quality of patients in our country, or our lack to initiate any sort of self-help, these men and women still believe it is their responsibility to provide, provide, provide, as we continue to demand, demand, demand.

In no way do we apply, give thanks, or attribute the respect that these physicians deserve to them regularly. Instead we threaten their practices, their homes, their integrity and we questions their desire to practice medicine; which is perhaps one of the most dangerous things that we as a country can do.

When we demoralize these physicians, we show no respect for their hard work, for their lives being given up to take care of sometimes fifty to sixty strangers a day, then we give up on the survival of humanity. We give up on the people that provide regularly and we give up on the best healthcare system in the world. With lowering our respect for physicians, and only increasing our uncontrolled, invaluable ability to self-proclaim what we as individuals believe that we deserve, we put these men and women in extremely compromising positions. Positions that not only will cause them despise their patience, despise healthcare, but to ultimately despise the practice of medicine; if we continue down this path, our physicians will no longer be practicing for the right reasons, our doctors will no longer desire to have educations that place them hundreds of thousands of dollars in debt, and we will no longer uphold the strongest medicinal system in the world. We will fall, and we will suffer and we will hurt, because there will not be anyone on the other side to take care of us once it is all said and done.

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Comments

Anonymous
As a physician, i thank you for writing this

Anonymous
Great article. I’ve spent almost ten years counseling physicians to remember that they do own a business and that making a profit is not only okay its necessary for survival. Patients don’t work their jobs for free, why should their doctors?

As a nation we have forgotten that physicians are small business owners and have overhead to meet and staff to pay before they can pay themselves. This is frustrating for me, because there are too many good doctors that are on the brink of losing their practices. The costs associated with accepting Medicare and other insurance plans can and do outweigh the benefit. We have many wonderful clinicians who care deeply about their patients and love what they are doing, but are getting burned out by the hours and the number patients they have to see each day just to keep their practices afloat. More and more are forsaking this antiquated system and moving into more profitable, less stressful cash based practices. I know because I’ve helped them make the transition. Survival instinct will overtake the system at some point and a change will be forced whether patients are ready or not. In no other industry are services provided by highly skilled, well-educated professionals who then wait (and hope) he or she gets reimbursed for their effort by a third party. Labor unions would have a field day with this.

http://www.cadencemed.com/blog Matt Langan
Lonestar, you really should write a guest post about how many practices are forced to moving to cash-based models. I think it would receive a great deal of buzz on here.

Anonymous
Thanks Matt!

http://www.facebook.com/people/Steven-Reznick/100000549195050 Steven Reznick
Thank you but please remember our eyes were wide open when we chose to enter this profession and despite the obstacles and impediments placed in our way by insurers, employers, government bureaucrats,non profits masquerading as the public watchdogs we love being given the opportunity to help people.
My new first year medical student made her first outpatient clinic visit to my office this week and as nervous as she was , I was almost as nervous about providing an excellent mentoring environment This bright and caring young women is starting medical school at age 18 and was mature beyond her years. .Her first question was ” I am accumulating at least $150,000 in debt to pay for medical school. Do you think I will be able to pay it off and how long will it take?” These are real issues that need to be addressed if we wish to have the best and the brightest and most caring continue to enter this profession
Anonymous
Thank you for writing this. And I hope your thinking is spreading in the public.
http://pulse.yahoo.com/_3CY2U67646G7UIAHBQVTT2UP4Y Kristy S
This is an amazing article. Thank you for writing it.
http://www.cadencemed.com/blog Matt Langan
This is a very refreshing article providing a perspective that I think most patients would share if they really sat back and considered all that goes into becoming a doctor and all that they are continuously being asked to do day in and day out. Unfortunately our healthcare system demands even more from these humans…so much in fact that they almost must become superhuman to wear all of their hats while sporting smiles.
Chrysalis Angel
Well said, Rachel.
http://www.lateenough.com Alex@LateEnough
Here here.
http://twitter.com/spencerhamons Spencer Hamons
Excellent article. Being in the health IT field, I interact with a lot of physicians who face the exact situation you describe here, and I have to admit, they do so with a pretty good attitude for the most part. On the other hand, my Brother-in-law is a pediatrician and has a successful practice…but his business skills were learned outside of medical school. I think multiple aspects are at play here, the first is the topic of your article. Another aspect is the failure of medical schools to give attention to the changing business environment of healthcare today in the United States. While these schools graduate extremely competent clinicians, these newly minted physicians often are clueless when it comes to the nuances of business administration. This failure isn’t just relegated to medical schools though, nursing programs across the U.S. fail in the same area of study.
Luckily, the industry is moving towards a more collaborative environment between physicians and hospitals and this may be the life ring that helps bring physician profitability back to reality.
Milan Radojicic
Thank you for the article and your wisdom!
Additionally, let us not forget the physicians who innovate and teach in addition to providing clinical care. A physician innovator and teacher is a living monument that we owe our medical progress to. If we neglect to honor and reward such individuals, we are stealing from our own future well-being. Beyond the general public, I hope your article resonates with our institutions, not limited to the insurance industry, the legal industry, the NIH, the USPTO and Big Pharma.
http://www.facebook.com/people/Craig-Mander/649389228 Craig Mander
While this article does shed “some” light on the physician/healthcare/patient dynamic, what it fails to address, is the medical training that teaches physicians to disassociate themselves from their patients! So why the complaints about disrespectful patients? Many Dr’s [routinely] are very dismissive to their patients and emote horrible “bed-side” manner. Plus, these Dr’s make a shitload of money…..they are not “struggling” in any sense of the word. Let’s not even discuss the deplorable “abusive” temper-tantrums, which routinely take place during surgeries!! ”God-complex” IS very real!!! So, want respect?…..”earn-it” and understand and learn people skills! How about inter-relational people skills…is that taught to physicians?…NO…is the answer!
No BooHoo’s here!
Anonymous
The same could be said about public education teachers.
http://pulse.yahoo.com/_HW2PF5TEFUQOVMX3FA3PZYJHFI Ralph
Physicians have a skill which should be appreciated. Should we all become great friends and pals because of that? Let’s see… 60 patients in say, ten hours(?) equals six patients an hour or about ten minutes each if they are stacked and no breaks or lunch or potty outs let alone Rx writing and whatever their business deals call for.
So maybe it is actually less than ten minutes a shot.
I doubt the doctor has time to develop a great, meaningful, pesonal relationship with everyone he/she treats.
Today’s physicians are skilled businesspeople. Think about it.

http://www.cadencemed.com/blog Matt Langan
Perhaps a doctor in this scenario needs to see fewer patients. At what point does seeing so many patients result in a significant drop in patient satisfaction, which would jeopardize their loyalty and eventually the doctor’s profitability? It’s a delicate balance between quantity and quality, no?

http://www.facebook.com/people/Jim-Reeds/708923562 Jim Reeds
I am very fortunate — I was raised in a family who were lucky enough to view
physicians as people first. My Mother was an RN, and many of our great
family friends were physicians, nurses and pharmacists, and we socialized
frequently. Only incidentally and over time did I begin to appreciate the
mastery of overwhelming knowledge and skills that were required to perform
any “job” in the health care field. After all — the highest responsibility
was always implicit: the saving of human lives and the preservation of human
well-being. I wonder how many of “the rest of us” could measure up to those
lofty goals?
I must say, I’ve never quite understood how it was that those who pursued
such noble goals could be viewed as “the enemy,” or as major contributors to
the ills of the U.S. health care system. I realize that as in any
profession, there are those that may not measure up. But we should take
care not to oversimplify the nature of the challenges that confront our
health care system, and in so doing, fall to the temptation to castigate an
entire profession. That in itself is simplistic, if not cowardly!
Let’s begin to repair the situation by extending a sincere “Thank You – For
All That You Do” to our own physician(s) the next time we meet them.
And…do not stop there. Make sure that you do the same to all of those in
the health care system that we encounter. We Simply cannot afford to lose
these invaluable professionals at a time when we need them the most!
So:
Thank you, Michael!!
Thank you, Ardeshir!!
Thank you, Dana!!
(And ‘Thank You’ to all of your staffs, too)!
James D. Reeds
Anonymous
How much I agree with you. Here in the UK, dispite two Department of Health papers “The Invisable Patient” and “Mental Health Care of Healthcare Professionals”, there is very little help or support for doctors to access funding when they need inpatient treatment for Addictions or Mental Health issues. Baybery Clinic in Oxfordshire, is the only treatment centre for Impaired Healthcare Professionals and we struggle to get funding for such doctors who, by the very nature of their condition, are unable to work and often in debt which adds to their already stressed state of mind. Absolutley sheer madness. Help for these doctors and support for their families are a MUST in our so called “Careing Society”. Maureen at Bayberry Clinic.
http://www.proactive-health.org Ryan Kain
In part, I disagree. Yes, physicians are people, and there are good physicians who are good people out there. BUT, there are many who still have the old god-complex, have no compassion or consideration for patients or colleagues, wouldn’t know current methods and research if it hit them in the head, and desperately need to be driven out of medicine. Many of the problems US physicians are dealing with are as the result of these physicians and the culture they built, and its perpetuation “because that is the way is has always been done.” But then, maybe it is just a bad day and just my area’s medical physicians who I have a hard time crying for when the rest of us have to pick up the pieces when they cast suffering patients aside just because the patient dares to challenge the physician, be it verbally or intellectually (see recent post regarding “idiopathic patient” who are a majority of my patients). Physicians are people; well, so are patients. If some physicians were to start treating patients like they are humans with problems rather than just problems, maybe people would return the same consideration and respect. As for the physician community having a much higher addiction and abuse problem than the general public: that is pride and ego at work, and the “poor me” syndrome. This forum is too short to get in to the other side of the coin with lists of trouble patients, the American patients’ expectations with lack of consequences, but suffice to say I applaud the public throwing off the god-complex mantle physicians have hid behind and I cheer on patient-centric and consumer-driven medicine efforts. All of that being said, I am new to this forum and see many good comments by many [apparently] good physicians who are at least trying. I cheer them on, as well. I loved the recent post by the orthopedic surgeon texting patients when he is running late -a great example of the new physician and solutions to the challenges in the modern health care arena.
http://pulse.yahoo.com/_7J26AFKJH5L7GPSK4SLFDDPKB4 PowerNSilk
I have worked in healthcare over 30 yrs. and I, for one, am passionate about my job. Im a traveler, have seen many areas throughout this country. As with all industries, our country has for the most part, a huge provider of “genuine, right kind of care”, godly, unselfish, sacrificing, professionals who give of themselves without limit. Physicians are only human, but have more asset to offer than the 99% of our population. The genius that practices medicine in this society truly has godly gifts. Look inside your local hospital, look at these gifted individuals and thank GOD that you do!
http://www.facebook.com/dr.rich.olson Rich Olson
I agree. And actually go further to say we as physicians may have been held to an impossible standard – during training and medical school – by our teachers. The guilt of not being perfect was strongly instilled, in our cohort, to my recollection.
Now when working with newbies, I have encouraged them to reconsider their daily work as endless opportunity to find the best way to contribute, presuming their caring, compassionate nature. I re-orient their concern toward the patient, and away from avoiding error. Then, when unsure about a decision, get social. Discuss with colleagues, with me, or a friendly book or online source of advice.
Patients seem usually to like having a ‘real person’ not an ‘ideal physician’ as theirs. Usually. If not, that person often holds a world view of entitlement – a difficult challenge for all of us humans. But worse now are the regulators, and their rules, that demand perfection always. Date and time each and every signature, even on a transcribed, dated and timed document? Bah.

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