Doctors need to stop being so complacent

Four brutally honest declarations:

1. I am perfectly capable of deciding what is best for myself, my family, my patients, my practice. I don’t need outside guidance telling me how to lead.

2.In order to practice the very best medicine, I decide what works best on my terms.

3. I will succeed and lead because I am focused on my goals just as much (if not more) than my patient’s goals.

4. My goal is to make money by offering tremendous value to my patients.

C’mon doctors, time to wake up! Yes you, the one who’s been seeing patient’s the same way our teachers an mentors saw patients in the same type of exam rooms, in the same types of hospitals.

Yes you! The one who seeks to write prescriptions first and make connections second. I know you’re busy, you have a lot to do. You have cases in the OR and patients to see and prescriptions to refill. You have to call Mr. Smith back today. And don’t forget to write that letter for Ms. Betty. It’s a challenge being in medicine, isn’t it?

But, come on, we can do better, you can do better. It’s time for some honest one on one talk. The kind that doesn’t come across the internet very much.

Why are we not leading ourselves where we want to go?

Medicine, and that includes you, is being lazy.  There, I said it.

No, not lazy, in terms of how hard you work, seeing patients and playing by the “rules,” but how you are innovating and adapting and acting for your future, for your patient’s future and most importantly for your family’s future. If we are to be completely honest, then I think we as physicians are failing ourselves, our patients and our families on many levels. Why?

The vast majority of doctors these days don’t know a thing about social media or how to connect with their patients with the tools of this digital age. Heck, only 33% or less of us, use electronic medical records! Come on!

I know, you may say, we have no other choice. The issues that plague the healthcare system are larger than any one of us and we need to be patient and let everything play out. Really, are you serious?

Why is it that for the vast majority of us, we are okay and fine practicing our trade in a system that is at best unpredictable and unreliable and at worst, one that does not reward our efforts?

Why do we allow ourselves to be dictated to over and over again and suck it up in the name of “being a physician”?

And why are we so scared to make change? Why is this so difficult?

If you were in any other sector of our economy, you would not just sit back on your heels and allow your day to day profession and livelihood be dictated to you. You would not stand it if over time you kept getting paid less and less while your responsibility increased more and more. There is no way you would allow yourself and your family to continually be put on the chopping block.

Am I over-exagerating? Maybe. But not really. C’mon, we all have the sense that medicine and healthcare are not what we dreamed of. No, it is not all about the money. But when we go through all of our training and determination and time and energy and yes, financial commitments that we all make, then, of course, it is reasonable to want to be the driver and not the passenger.

But right now we are okay with sitting in the way, way back as someone else steers us around. It is okay for our careers and dreams and aspirations to be dictated by someone other than ourselves and our families?

Why are we so complacent?

I think it is part fear mixed with guilt. We fear rocking the boat and taking control of our daily practices and we feel guilty for wanting to do so. But fear and guilt have never led to any positive changes. You know this.

We talk a lot about reform and change and wanting the best for medicine and our patients. But if we truly want to right our ship, then it is time for us to lead and not follow. To take two steps forward because we know where we want to go — and not look back.

Yes, we will make mistakes and yes, we will not always do the “right” thing, but ultimately if any of us wants a better medicine and a better healthcare system, then it has to start with each of us actively making that choice and living it.

If we are always trying to base our decisions on what is good for our patients or good for the system, then we are failing ourselves (and ultimately our patients and the system itself). The only way we can lead is to do what’s best for us. And that means what is best for ourselves and our families.

I’m guilty of being fearful, too. I am just like you. I think we have been lazy for far too long hoping that we can all band together and find a solution. Well, this just in, that’s not happening. At least it’s not happening fast enough.

High time we were finally honest with ourselves:

1. I am perfectly capable of deciding what is best for myself, my family, my patients, my practice. I don’t need outside guidance telling me how to lead.

2. In order to practice the very best medicine, I decide what works best on my terms.

3. I will succeed and lead because I am focused on my goals just as much (if not more) than my patient’s goal.

4. My goal is to make money by offering tremendous value to my patients.

Simple, yet for most of us, we have trouble believing these to be true.

Craig Koniver, author of Connected: The New Rules of Medicine, consults with physicians around the country at The New Rules of Medicine.

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  • TheresaWillett MDPhD

    I very much appreciate your rally cry to the fearful physician masses!  I have gotten myself into no small amount of trouble by setting my sights on a future state, and working toward that by every means possible. I would hope, though, that there is still room in the battle hymn’s second section to include evidence-based-medicine and properly implemented lean measures. Efficiency and standardization do work in medicine, when developed well. In those cases we need to take this lagging reinvigoration to full throttle, accept and encourage innovation at every level, while following our oath to protect and serve our patients.

    • Craig Koniver, MD

      I agree–we certainly do not want to dispose of modern medicine at the expense of wanting a better medicine. Each of us has our unique slant/view/perspective on how best to serve our patients and ourselves. I feel that we will do everyone better by leading with our personal goals in mind. Yes, many people will disagree with this and say that health is about all of us. But at the end of the day, medicine is a business and in order to make each business/ practice thrive, we need to focus on want each of us wants.

  • brian

    Physicians used to be the Healthcare leaders in this country.  We physicians (thanks in large part to the AMA) have allowed ourselves to be sidelined to the role of “providers.”

    the passage of last years healthcare law made it VERY clear who is now the healthcare leaders in this country.  Pharma, Insurance, and large hospital groups.  they were the only ones at the table while physicians just looked on.

    the ama?  they were so consumed to have gotten the “plastic surgery tax” taken out they missed every opportunity to actually make a difference.  and yet, they were so proud….

    I applaud your stance.  until Physicians stand up for themselves and stop allowing the system to dictate our care and relationships with pts…. healthcare will cont to be mediocre at best.

    I take it one step further.  We should boycott the AMA and form a new TRUE physician organization…. 
    but we need a leader…. anyone?  most of us are just to busy actually trying to survive in our practice….

    oh well.

    • Craig Koniver, MD

      I agree that big organizations like the AMA do not seem to have the individual physician’s interest in mind….I think, for now, we are better off going about creating our own practices the way we want them to be created. Just like every other industry out there, medicine is a business, and even though it is more personal, it is a business, and as managers of that business, we need to make that business thrive. I think we have for far too long placed others wishes, desires, and goal above our own…

      • brian

        very Ann Rand.  I agree.

        Who’s John Galt??  :) 

  • Anonymous

    I work for a hospital.They tell me what to do. They work for the government which tells them what to do.
    Get off your high horse  and face up to reality. Our role in running  things ended  back in the 80′s when
    the morons from the Joint Commission showed  up.

    • Craig Koniver, MD

      It’s unfortunate that you have the attitude that giving up is better. Certainly that is the easier path and also the path more followed right now. But why not engage in what matters most to you and make those changes, one at a time, until you can have the practice, career that you want most?

  • Bruce Ramshaw

    The passion and sentient are great and very appropriate- we, as physicians, have almost completely relinquished control of delivering care for patients (outside of the direct physician-patient relationship).  However, it is the individual physician practice model (I can do it myself, just leave me alone) that is part of why we are in this situation.  We asked hospitals to give us all the resources we need to care for our patients, and guess what, they did that and became very powerful because they now control all of those resources (and they have become very comfortable with this status quo- getting the majority of the reimbursement for the work done by physicians).  I believe the solution is not going back to the “cowboy” individual physician model, but having physicians exhibit humility and working with patients and other stakeholders to evolve a new care model. It is critical to not go back to the thinking that got us into this mess, but to evolve our thinking to understand we cannot do it ourselves, but we should be leaders in building new care models and care communities to evolve our health care system to one that is sustainable.  

    • Craig Koniver, MD

      I agree with you that we certainly do not want to move forward in a way that is too cavalier, but I think we would all do better, for now, to just go for it and shape our very own practices the way we want them to be shaped…more innovating and doing and less worrying about the ramifications…

  • Chris OhMD

    The current healthcare environment presents challenges but also presents with many opportunities for innovative thinkers to reinvent themselves. As a solo practitioner I’m very excited about the future and the things I can do on my own by utilizing EMR, social media to improve both my own efficiency as well the healthcare delivery itself. I think too many doctors are complaining and missing out on the opportunities to reinvent themselves. Great article.

    • Craig Koniver, MD

      I completely agree–too much waiting and waiting for something to happen instead of making something happen. We need more action and less talk!

  • Barack Hussein Obama

    As I understand it, we can’t unionize, strike, or collectively bargain, leaving us powerless as a group.  The only alternative is to walk out of all insurances, Medicare, and Medicaid and “vote with our feet” by becoming cash practices or concierge models.  These are not solutions for doctors as a whole, since there  are not enough patients who could afford this.  

    I hate to say it, but the govt. has us by the b…..s.

  • rich

    If you want to keep working and give you r sweat and tears to make others rich, keep doing so; otherwise quitor work for the va and keep some dignity…

  • Anonymous

    Why is it that any “connected” individual who posts an opinion on KevinMD always has something to sell (ie book, consulting, etc)?

  • David De Groot

    Definitely like what Bruce Ramshaw posted below. I also would like to offer that medical malpractice is another reason why Doctors are likely so scared to try something new. See this article for some of the psychological impacts of the threat of medical malpractice: 

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