Physicians have had it. What do we do now?

I keep reading about how physician’s rightful bitching and moaning is peaking at an all-time high. It’s time they do so before the bow breaks, and let me tell you — we’re almost there. The worst problem that persists is “the enemy within ourselves.” This voice of doubt keeps us from the next logical step: stop what we’re doing, revolt and disable a broken runaway system lest we all soon go down with it.

This “enemy” is our own disbelief and the loss of faith in ourselves and our cause. After all, we are the real “cause” of helping the sick, wounded, hurting and afflicted ones in our nation — not some paper-pushing, cash-hungry bureaucratic machine that could care less about our nation’s sick and ailing, let alone about us. Unfortunately, the state of the union in health care will probably have to really get even worse for the nation to see just how important physicians are and how they carry the real weight when it comes to America’s medical needs. Either we get a top seat at the bargaining table, or we walk away and start our own negotiations. The nation is yearning for those of us who care for and treat them to be the ones who negotiate their needs. Will some senator from the Midwest or insurance executive know how to stop the pain and suffering or ease the plight of our nation’s families?

It’s no longer feasible to allow a bunch of MBA medical novices, insurers, and all the other power brokers to bankrupt our nation on the backs of doctors without whom they would soon all change their business ventures to non-health care pursuits.

Yet, physicians prefer their own crying games as the real powers in health care carry the day with unlimited time off to enjoy (unlike physicians). These mega-billion brokers take home no onerous EMR’s to complete after struggling with late after-office hours. So as to complete ridiculous measures, they are required to implement purposelessly in order to “possibly” see a minuscule rise in their compensation. In fact, these time-consuming and costly MIPS and MACRA burdens further torture physicians as they are at best worthless to patients. Why haven’t we had enough?

A tough question? Not really. So what exactly is it that holds doctors back from striking or refusing to work for wages equaling less than fees they could get for parking cars? Perhaps it’s an embedded fear from as far as back as medical school, enforced by residency and later by licensing agencies, insurers and the government. All this is topped off by a derogatory and demeaning media portrayal and governmental scapegoating of our profession. So sure, they give up and continue in misery — wouldn’t anyone?

But how long does anyone think this can continue?

Think about it. Do physicians have any real power? Licensing agencies do, insurers do, the pharmaceutical industry and the government certainly does — all of them over physicians. And yet, physicians have no power over anyone, especially themselves or their patients. Of course, this is totally unacceptable, irresponsible, unethical and disastrous. But it continues as you read this.

In essence: if we stopped working, the nation would be paralyzed. How can this ever happen when it is us who are already paralyzed?
Instead, we lay powerless leading woebegone, paralyzed lives of frustration. Yes, we’re prisoners of a very crooked system who have us by our physical as well as psychological chains of our own “stethoscopes.”

Everything we do is scrutinized, analyzed, pre-calculated, paid upon contingency for fear of revocation with fees continuously demanded and collected, penalties imposed and then the requirements. These requirements are continuously and onerously piled up so, in effect, we can either choose to burn out, commit suicide, leave the profession but never seem to hold a “snowball’s chance in hell” of ever even partially controlling our own destinies or that of our patients.

Perhaps lessons from Gandhi’s nonviolent revolt and boycotts might spark a familiar sentiment in many of us. Imagine if physicians all refused to do MIPS, MACRA or other nonsensical trick or treat onerous worthless puppeteer measures? Will we all stop getting paid or get less from Medicare? How much less will that be as they’ve already whittled us down to bare minimum — all the while continuing to generously allow pharmaceuticals and insurers to rake in “sky’s the limit” charges.

Well then, just maybe we might get a say in what measures we believe are important to improve the quality of the life of our patients without suffering burn outs along the way. Perhaps we might get paid by insurers without fears of having these payments refunded with interest or simply refusing to pay for our hard-earned work at their whim. After all, who ever heard of getting paid without guarantee of keeping one’s fees? Sounds like “funny money” to me. Too bad it’s we who are made to look like clowns. We’ve got to be heard now. Later will be too late as the siege upon physicians continues to take no captives.

It’s no wonder that so many pre-med students abruptly switched to becoming NPs or PAs or even more so chose non-medical careers.

Will we congratulate our oppressors for destroying an amazing field of higher calling, or will we have the courage to start speaking up and finally take back our noble profession? It’s totally up to us to make an important life-changing impact today. As a profession, we’ve been forcefully taught about documentation so how about we all document what’s happening to our profession and how it affects our patients’ lives as well as our own?

I’m sure you all have highlights of your own plights and travails you can share and lend a powerful sorely needed voice to help share with our nation, elected officials and colleagues to affect vital changes today. Thus, we might actually assure both the continuity and brighter more hopeful future for newcomers to our embattled profession. After all in 1776, 5 of the 56 signers of our Constitution were physicians.

In 2013, there were 21 physicians in our congress. That number dropped to 11 in 2017. So in 1776 about nine percent of signatories of our constitution were physicians, whereas, today it’s one percent or less. Let’s take back our voices so the muffled heart sounds of our nation can once again be clearly heard.

Michael Weiss is a physician and can be reached on Twitter @HeartAndSoulDoc.

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