Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A divided house always falls: Why doctors lost control of health care

Suneel Dhand, MD
Physician
January 15, 2019
102 Shares
Share
Tweet
Share

I recently met an old friend of mine for the evening in New York City. He’s a talented young orthopedic surgeon, who has already, in the short amount of time since finishing residency, experienced so many of the problems our health care system faces.

The topic of conversation quickly turned to the current state of medical practice, the dramatic swing to corporate medicine, and the consequential loss of autonomy suffered by physicians as a result. I asked him what his views were on why doctors appear to have lost control over their profession.

He said something very profound: “Oh there’s a simple reason for that Suneel: It’s because doctors don’t get along.”

That was his single one-sentence summary. He then expanded on how he believed that as a group (considering there are close to a million physicians in America), they could have immense collective power and advocacy. But because we are so fragmented with our own selfish interests, we exponentially diminish any power we have.

He went on: “An orthopedic surgeon doesn’t really care about what’s happening to an internist, and vice versa too. We are all solely focused on our own area of practice, work environment, and income. There are far too many big egos running around, and what’s worse is that doctors frequently fight with each other as well.”

All the while, our health care system continues to decline, and patients bear the brunt.

I thought that was so true and haven’t ever considered it in such simple terms before. My mind turned to how this could actually be a story of a million-and-one scenarios in life: A divided house always falls. And that always leaves the door open for a third party to come in and take advantage. I actually started thinking about another story that I grew up with.

Being of Indian descent, for some reason the story of British rule of India came racing to my mind (albeit on a much larger scale with bigger consequences). India was a land of princely kingdoms back in the middle of the last millennium, unable to get along with each other. Of course, it was a dog eat dog world back then, and might was right. Whoever was the strongest with the mightiest armies, took control. In came the British with their East India trading company, initially under the rule of Queen Elizabeth 1st in the 17th century. To cut a long story short, the British cleverly exploited the divisions for their own good, implementing a classic “divide and rule” policy.

In a relatively short amount of time, they had gone from trading a small amount, to gaining complete control over a massive country — while forming “deals” with complacent local ruling maharajas to keep them “comfortable” (inevitably these maharajas would realize that perhaps the deals were not worth the loss of control and autonomy, and that they had been played by an entity that viewed them solely as a commodity, but this would come too late).

I am of course giving a very simple account here for this article, but the broad theme is the one to grasp. Who could blame the British in the world as it was back then for cleverly doing this. Nearly every king and country was at it, if they had the means to do so, to expand their power and gain wealth (as an Indian, part of me is actually grateful it was the Brits with their relative fairness rather than a more brutal and murderous force like Imperial Japan or Nazi Germany).

Perhaps there’s also an argument to be made that India would have even fallen apart on its own, had the Brits not come in at that point in history — but that’s another story. One can never view historical stories through the lens of today’s standards.

Thankfully the world progressed, and India was able to gain the self-rule that any group of people or country must have. But it took a few hundred years, unfortunately, after their divisions had been exploited by an external entity for their own benefit.
The story of how the British empire took over India, is one of the most classic large-scale examples I can recall of a 3rd party cleverly taking advantage of a divided house. I encourage anyone to read the fascinating history in more detail. This timeless scenario plays out everywhere every day, from your own individual home, community, business, right up to a national level. It’s a timeless tale.

But back to health care: I’m just sad it happened to doctors too.

Suneel Dhand is an internal medicine physician, author, and an independent health care experience and communication consultant. He is co-founder, DocsDox.

Image credit: Shutterstock.com

Prev

A call for the end of routine opioid use after wisdom tooth removal

January 15, 2019 Kevin 0
…
Next

Why is Medicaid reimbursement below sustainability?

January 15, 2019 Kevin 12
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
A call for the end of routine opioid use after wisdom tooth removal
Next Post >
Why is Medicaid reimbursement below sustainability?

More by Suneel Dhand, MD

  • The dream patient that makes a doctor very happy

    Suneel Dhand, MD
  • When the family wants to speak to the doctor

    Suneel Dhand, MD
  • 3 reasons why patients are unhappy

    Suneel Dhand, MD

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Why should health care professionals care about gun control?

    Sobia Ansari, MD, MPH
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • Doctors and patients should be wary of health care mega-mergers

    Linda Girgis, MD
  • Almost half of health care workers are not doctors and nurses. Health policies must address their burnout too.

    Irving Gold
  • Health care organizations: Clean up your house first, then you can tackle racism in patient care

    Nikki Hopewell

More in Physician

  • Challenging the diagnosis: dehydration or bias?

    Sydney Lou Bonnick, MD
  • Practicing medicine with conviction

    Arthur Lazarus, MD, MBA
  • The power of memory in shaping human identity

    Emily F. Peters and Sandeep Jauhar, MD, PhD
  • Physicians have no autonomy. Here’s how to change that.

    Diane W. Shannon, MD, MPH
  • The erosion of patient care

    Laura de la Torre, MD
  • Navigating adulthood in the digital age

    Eleanor Menzin, MD
  • Most Popular

  • Past Week

    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • Exploring HIV care and advocacy [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
  • Recent Posts

    • Exploring HIV care and advocacy [PODCAST]

      The Podcast by KevinMD | Podcast
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • The art of pediatrics: Connecting through observation

      Alexander Rakowsky, MD | Conditions
    • Assertiveness in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Epigenetics and our inheritance to future generations

      Vishruth Nagam | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Lab Tests That Escape FDA Oversight May Come Under Agency Review
  • Fezolinetant Benefits Women Not Suited for Hormone Therapy
  • Low Tidal Volume Compliance Still Lacking in Mechanical Ventilation
  • IV Immunoglobulin May Cut Infection Risk of Anti-BCMA Agents for Myeloma
  • When's the Best Time to Get the Updated COVID Shot?

Meeting Coverage

  • Fezolinetant Benefits Women Not Suited for Hormone Therapy
  • Plant-Based Estrogen Improves Lipids in Postmenopausal Women
  • New Schizophrenia Treatments Are Coming: Don't Panic
  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • Most Popular

  • Past Week

    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • Exploring HIV care and advocacy [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
  • Recent Posts

    • Exploring HIV care and advocacy [PODCAST]

      The Podcast by KevinMD | Podcast
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • The art of pediatrics: Connecting through observation

      Alexander Rakowsky, MD | Conditions
    • Assertiveness in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Epigenetics and our inheritance to future generations

      Vishruth Nagam | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

A divided house always falls: Why doctors lost control of health care
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...