The euphoria of becoming a physician did not last long. My scrubs did not even lose the fresh scent, and I was already under attack by the administrators. Over the next few years, I was injured, morally hurt, not able to fight back, sad, and disheartened. After finishing my residency, I experienced physician abuse and attacks on my self-esteem in every job I took through administrators who did not understand my work and imposed their viewpoint on me. The abuse would start at the federal level by laws written by those who we elected to improve the health care system but were secretly designed to weaken physician control of health care.
Institutional abuse has a methodology. First, you buy physician practices, making them employees, taking control of medical staff by putting hired physicians to do the bidding of the MBA-holding executives. This is followed by the implementation of workflows in which physicians have to do everything themselves so that quality of care can be maintained. The mantra of physicians does it all obviously backfires as it puts tremendous psychological and physical strain on physician well-being. Left unchecked, this leads to moral injury on a global scale that we see today. If government-run mandates like Medicare for all are passed, it will lead to increased physician dissatisfaction and will completely suck the joy out of the practice of medicine. This has already been seen in national health systems in countries like the U.K. I personally know of physicians who work in that system. One of my colleagues, who is a cardiothoracic surgeon in England, was rudely interrupted by an administrator while doing rounds on postoperative patients to take consent on a patient that was getting a chest tube electively the next day. I guess patient satisfaction was tied to the administrator’s compensation.
The scrubs have been taking a beating. This has now been going on for the past two decades. We are injured and hurt. Our reputation has suffered. The suits were able to denigrate our previously high position in society by creating an image of wealthy and corrupt physicians. They successfully relegated us to the rank of providers. They shoved cookie-cutter medicine down our throat, and those that had the courage to fight back were marginalized as disruptive physicians.
The suits have also been able to divide health care professionals. Physicians, nurses, pharmacists, physical therapists, respiratory technicians, and nutritionists have all been made to fight their separate wars against a bureaucratic system that has been imposed on all of them. The divide and rule principle has served the purpose of the suits who have taken credit for all the care that is provided, and the administrators have also been benefiting financially from the hard work that we have been doing together. They have been successful in convincing even the physicians that they should not take their rightful place as health care executives and leaders. Physicians have all the responsibility but none of the authority. Wouldn’t that make you sad? This might explain the rise in physicians taking their own lives in the past decade.
COVID-19 given health care professionals who are fighting this battle at the front line, an opportunity to redeem themselves. The public can finally see that when we fight something together, we are like soldiers on a battlefield. There is tremendous goodwill directed towards health care professionals. The scrubs are putting their lives on the line. We have lost our colleagues and some of our frontline workers in this battle against a very powerful enemy. Public sentiment is now back on our side.
I implore my fellow colleagues to not lose this opportunity. We must not let the suits take this as some sort of victory for themselves. Already I am seeing hospitals and big systems taking credit for the fights that we are fighting on the front line. They are portraying themselves as some sort of heroes and are looking forward to financial bonuses that they will enjoy after the pandemic. They will not lose their lives, but we will. The leadership should not come from them. It should come from us. The scrubs must fight back. We are already seeing that administrators are disarming us and taking away our masks and taking us to battle without the right personal protective equipment. Horrible stories are coming from across the country as physicians and nurses have been fired by these suits for standing up for their rights to protect themselves. If we choose to continue to work selflessly and do not come together as physicians and health care professionals and take back the control of health care from these power-hungry suits, we will continue to slave away and continue to get injured as more and more rules are passed that continue to undermine our autonomy and kill the art of practicing medicine.
If the scrubs realize their potential and rise up against the suits and ride the wave of goodwill that has been created after the pandemic is over and don’t fight among themselves, we have a chance to get back what we have lost. The fate of our profession, our legacy, and the art of practice of medicine depends on it.
If you fail to act now, we can be assured that our sacrifices will be forgotten and the suits will have the final laugh when they will take all the glory at the end of the pandemic and go back to bullying us into submission as they have done for the past 20 years. I, for one, will not let that happen. I rebel against physician abuse. Physician strong.
Talal Khan is a family physician and can be reached at Personal Primary Care.
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