American doctors are unhappy about a lot of things. Americans, in general, are unhappy about a lot of things. In many ways, both groups share similar concerns. But the road back to happiness may follow a similar path for both, as well.
American doctors once felt part of something special. American health care, by reputation at least, was the best in the world, and we were its proud emissaries. We functioned with a satisfying sense of autonomy. Patient care was paramount, and the business of health care derived from that ethic, not the other way around.
And Americans once felt like members of a special club. America symbolized what could be achieved, in a moral sense and an economic one, when a people, a benevolent and effective government, and powerful industries worked together and, at least in some senses, in partnership, and for the greater good.
I know that I am painting an overly rosy picture. Things in America, for doctors or for the general population, have never been perfect. But the American dream was a powerful and arguably, a largely positive force for Americans (with exceptions). And the American medical system, American government, and American industry were something in which Americans took pride (again, with exceptions).
But much has changed. It is not a happy time. The American health care system may now be the worst in the world. And American doctors today are buried under a mountain of unnecessary, overbearing government regulations, and pushed about by giant health care corporations. Money drives the system. Likewise, Americans are being squeezed by a controlling, corrupt, and ineffective government, and a greedy corporate culture that values nothing other than profits. People exist to serve the system, where in the past we were in partnership with it.
But maybe worst of all is that, paired with those problems, today we are also a nation divided. We have always had divisions. We even fought a civil war over them. But except for that Civil War we have always been more united than apart. And our national trajectory was growing tolerance and acceptance of one another. But now it seems we are all at one another’s throats. It is painful to see: a significant source of our national unhappiness.
Doctors are as divided as the nation when it comes to politics and opinions regarding health care reform. But we also divide by specialty, and many of our specialty organizations divide by state, as well. We are a profession of factions. More than anything, though, we are kept apart by a lack of time. Most practicing physicians are just too busy in their professional lives to have the time to organize and work together on other issues.
And as we are all well aware, Americans divide by just about everything: political parties, professions, race, religion, sexuality, etc. You name it, we are divided by it.
But division is not just a source of unhappiness. It creates a bigger problem. A divided citizenry is weak and disorganized. We fight with one another when we need to be facing down our out-of-control government, and taking on the harmful effects of unfettered corporate greed.
The solution, for doctors and for the broader population, is to come together. The American government will not fix itself. Nor has it been able to fix the health care system. And corporate greed will not rein itself in. It will take a strong, united population to bring about such changes and to bring necessary balance back to the American equation. If we want to fix things, Americans must unite behind that which brings us together, and put aside our differences.
In fact, American doctors are looking for ways to do just that. Recognizing that organizations like the American Medical Association and specialty-specific professional societies are not getting the job done, new groups representing practicing physicians have begun to spring up. I recently sat in on a conference call where a number of those new organizations were in attendance. There were representatives from Practicing Physicians of America, Physicians Working Together, the Association of Independent Doctors, American Doctors Stand Up, the National Physicians Council for Healthcare Policy, Patients and Physicians United for Quality Medical Care, and the Association of American Physicians and Surgeons, to name a few.
It was interesting how the conversation played out. When issues concerning politicized topics such as the repeal of Obamacare were mentioned, there was little conversation. It was obvious that divisions ran deep. On the other hand, there was obvious unity when it came to conversations regarding topics like administrative overload and insurance company abuses. All doctors abhor the incredible amount of work it takes just to get paid for simple services, maintenance of certification, EHRs and the government’s crazy EHR Meaningful Use program, overly aggressive insurance company pre-authorizations, the insane new government “value-based pay” program (MACRA), and the fact that we are being forced out of our private practices and into corporate work camps. It appears that all doctors agree on the desperate need for administrative simplification and a far less intrusive regulatory environment. And this appears to be just the issue that could unite American physicians to form a more effective political force.
It is harder to say which issues could unite the broader American population. What is clear is that if doctors and American citizens remain divided to the extent that we are today, it is unlikely that we will solve America’s greatest problems. Only by coming together in new ways can we create a health care system where patients come first and a society where American citizens are back on equal footing with American government and the nation’s industries.
Matthew Hahn is a family physician who blogs at his self-titled site, Matthew Hahn, MD. He is the author of Distracted: How Regulations Are Destroying the Practice of Medicine and Preventing True Health-Care Reform.
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