Can you separate the businessman from the doctor?

An investment banker recently told a doctor, “I’d love a job where I didn’t have to constantly think about money.”

Oh, how wrong he was.

In a recent essay in The New York Times, cardiologist Sandeep Jauhar talks about the difficulty divorcing revenue from medical decision making. While moonlighting, he writes that, “It is hard not to order a heart-stress test when the nuclear camera is in the next room. Palpitations? Get a Holter monitor — and throw in an echocardiogram for good measure. It is not easy to ignore reimbursement when prescribing tests, especially in a practice where nearly half the revenue goes to paying overhead.”

But despite the fact that more doctors are pursing MBAs along with their MDs, the majority willfully remain distant from the business side of medicine. For the idealistic few, or for those who feel that patient care is the only thing that matters, the business of medicine has created, what Dr. Jauhar refers to, as a “a palpable sense of grieving.”  Indeed, as one cited physician comments, “You can’t survive with your head in the clouds.”

So, can you really separate the businessman from the doctor? Not in American medicine.

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