Every now and then, more often when on call, I experience what I think it was like to be a physician when I was a boy.
I remember the era of the house call. I remember the physician as a part of the community. You saw him around town, school, and at church. You knew his wife and went to school with his kids. I remember that. And I remember the physician being summoned to the home as we’ve always done. It’s our role to be there when needed. And often, physicians have not known all they needed to know about disease. And often, we haven’t had great cures.
But we could always listen and counsel and console. And in that way we cared, and sometimes we healed. But we offered something beyond pills. We offered help with life and sometimes death, too. We were there for the person, and we were there for their families. And we did our best and tried and sometimes made mistakes. But people were OK with less than perfect because they knew we cared and we were trying and doing our best. And sometimes it wasn’t good enough, and sometimes it harmed and even killed people.
But they knew life was imperfect and that we were only human and that we were truly trying. And sometimes they consoled us when things didn’t go well because they knew how badly we wanted to help and how sad we were that things didn’t work out and how gutted and nauseous we were when we harmed someone.
And now I sit at the nurses station waving to administrators walking down the hallway and I document what I did using some click-box program that exists primarily as a billing and inventory receipt. It contains nothing that speaks to what we really do. We look at documents that are all cut-and-paste, largely fictitious, and made fat with needless information so more money can be made: Look how hard we worked!
And I see that this is health care today. All the marrow is sucked from the bone. There is no life in it. And we pay ridiculous amounts of money to people who are businessmen and could not possibly care less about your health. And our outcomes are not good compared to the rest of the world.
I sit in my office and look at a copy of Sir Luke Fildes’ painting, “The Doctor.” The 19th-century physician staring at that dying child knew almost nothing compared to what we know today. And, yes, there have been many amazing medical and technical advances that have saved countless lives. But our profession was built upon that man at the child’s bedside. And we’ve killed him.
Michael P. Jones is a gastroenterologist.
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