Demonizing doctors won’t solve our problems

The process of becoming an excellent physician is one of mastery.  The passion of the child is replaced by the studiousness of the teenager, and the bottomless energy of the young adult.  The leap from decision to clinician takes decades.  Forged in the steel of experience, trampled by pain and tortuous repetition, ability accrues.

The apprentice guards his knowledge closely.  He bows to the alter of the sacred skill that he will do anything to attain.  There is nothing above becoming.  The mountain has many peaks and valleys.  One never quite reaches the summit. There are only gradations of closer.

The height of all these struggles is the clinical visit.  When done correctly, the conductor brings order, coaxing each nuance forward at the appropriate time and pushing back.  Pushing back.

Mastery of this process, this clinical encounter, means everything.  The pride and joy of a lifetime of work is condensed into a moment.  This is where knowledge meets art, passion becomes healing.  The only thing more sacred than the skill of the trade itself is the motivation that brought each craftsman to this place.  The hope to help our fellow human beings is what coats the bottom of the well.

But mastery has its limits.  The conductor becomes less effective if asked to also manage the lighting.  Nuance is lost if water balloons are hurled on stage during the most dramatic moments of performance.  And so it has become with physicians.  The dictates of electronic medical records, meaningful use,  and preauthorization are destroying the carefully crafted skill of diagnosis and management.  The drivel of health care reform has become the fodder of the clinical visit.

Physicians’ arms have been tied behind their backs.  Now we are being blamed that no one is guiding the ship.  You can’t demand that doctors improve health care quality and cost, yet handicap our most basic unit of skill: our mastery.  You can’t complain that we are doing a poor job, yet pull our laser-like focus away from the patient and point it towards a computer.  You can’t have your cake, and eat it too.

We complain about salary because it is obvious.  In the face of greater regulatory demands, increasing overhead, and more intense scrutiny, physician salary has been flat when adjusted for inflation.  For must of us though, money is not the issue.  It’s more about value.

The demonization of a once proud profession will not solve our problems.

It will, however, alienate us from those we are supposed to be serving.

Jordan Grumet is an internal medicine physician and founder, CrisisMD.  He blogs at In My Humble Opinion.

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  • NewMexicoRam

    I’m standing and cheering right now.

  • Dike Drummond MD

    In my experience there is a disconnect between the demonize get of physicians we see in the press and how the average person views their doctor.

    The press and policy makers see us as over treaters and the source of the cost over runs of the US health care system. They are correct AND we are just doing our jobs. If you pay more for more care what do you expect?

    At the same time the average patient likes, respects and defends their personal physician, PA or NP.

    I hope and pray the patient physician relationship remains on of respect as we move from the age of volume to the age of value in the Post Obama care Era.

    My two cents,

    Dike Drummond MD

  • SteveCaley

    Who is John Galt?

  • QQQ

    The mainstream media will continue to bash doctors. Its a never ending cycle in a battle that is starting to heat up after the Medicare information that was just reported to the public!

  • Bryan Treacy

    This is very well written, succinct and, I suspect, is the way most physicians feel in these times of health care upheaval. I have managed to keep the ability to use my skills by shifting to a direct pay model. A shift to direct pay can be difficult but with insurance deductibles skyrocketing, patients are understanding that this model saves money in the long run.

    • Nancy

      I wish this encourages more physicians to do the same! I wish you well!!

  • Nancy

    This is no time to behave like a victim. Physicians need to educate themselves on the art of bring graciously assertive.

  • Nancy

    Very well written. Summarizes how many physicians feel. My concern is the tone of this excellent article. That a large group of bright and influential professionals sound like victims. I have always wondered why doctors can fight huge battles for their patients (very admirable), yet stand by and allow others to “tie their hands behind their backs”. I do understand that years of inculcation on self sacrifice and not complaining may foster a helpless trait in those same fiercely-patient-protective physicians. However, being ‘nice’ in this doctor-hostile environment is not only hurting the physicians themselves, but also their patients. This I do not understand.

  • Maggie

    How poetic and insightful, and what a passionate plea for understanding!

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