As has been much discussed in the last few years, our health care system is in crisis. We spend $3 trillion a year on Medicare. MRIs bill out at $5,000. My recent bilateral mastectomy totaled $33,000 with $800 of that actually going to my surgeon.
I left my role as an employed physician in the traditional insurance-based fee-for-service structure because I spent 80 or more hours a week typing, collecting data, coding, answering to documentation requirements and saying, “I’m sorry.” “I’m sorry I’m late.” “I’m sorry we can’t address this now.” “I’m sorry they couldn’t get you in.” “I’m sorry that other doctor made you feel like less than you are.” “I’m sorry!” Over and over and over again. Less than 40 percent of a traditional physician’s day is spent in direct clinical care. The rest is spent, often at night, on weekends and while on vacation … typing. Documenting. Recording what happened instead of being present while it is happening.
The beauty of doctoring is that, regardless of requirements, codes, systems, legislation — our profession has stood for millennia in service of our fellow humans. The word physician takes its origins from healer and the word doctor from “teaching.” So we, by choice, by training and by the legacy of our profession are “teachers” and “healers.”
We train to integrate all humanity has to offer — science, art, compassion, technology, education, innovation, spirituality, connection — to better the lives and the health of humankind.
The profound responsibility of this role is not lost on me nor on the vast majority of my physician colleagues. Doctoring is a highly privileged position, even at a time in history where our expertise and core purpose is under fire. Physicians represent the most educated people on the planet; we spend all day almost every day listening to the authentic stories of joy and loss and fear and pain and redemption. Our job requires us to remain on full duty in the most intimate, vulnerable, challenged moments of people’s lives. We see people at their weakest, at their worst, at their most dependent. And from that, it is our job to rise. To help our patients rise. To help humanity … rise.
It’s hard to maintain the perspective of influence that we have in our communities when the majority of our days are spent fighting with administrators and getting beaten up by what people read on Google. In many communities, the relevance of 24+ years of education, 100-hour work weeks, grueling testing, expensive and redundant licensure requirements and researched-based answers — all the things required of traditional physicians — this expertise is held on an equivalent platform with “my mom’s friend who is a nurse” strongly held opinion.
The problem is, traditional medicine has closed itself off more and more to the voices of our patients. We’ve stopped listening, and humanity has stopped trusting.
We label our own colleagues “purveyors of woo” when they step outside of our known paradigms of science. We point fingers at each other and argue openly with patients. We ridicule our colleagues, ourselves, our patients. We are non-participatory in our family lives and our own self-care. We have abandoned the therapeutic space because we are pressed for time, pressed for answers and because, daily, we are asked to generate codes to make revenue and because daily, we are abused.
What, dear doctors, what are we going to do?
The reality is we don’t know everything. We can’t know everything. And wouldn’t what we do be distilled to not-so-much if the mysteries of humanity were algorithms?
Fundamentally, in spite of all the abuse we take and how many people don’t seem to value the role we have in society, our voice still matters.
As we move away from abuse, go out on our own, recover — as we change care paradigms — let us find our voices again. Let us not join societies that peddle “woo.” But let us also be open to the fact that traditional medicine and science is a hypothesis-based investigatory process that is dependent on new discovery and evolution. Let us not dismiss what our patients tell us because it doesn’t fit within our framework. Let us rise up and begin to support our colleagues and other health care providers who are trying to make things better. Let us not join the masses in harmonious yelling about untruths, fake news, speculative accusations, and anger.
Let us rise. Let us lead. Let us show humanity what we are, what we can do.
We cannot move forward with a culture of infighting and antagonism. We cannot move forward with the expectation that everyone around us will see the world as we see it. And we cannot move forward speaking partially informed truths or pointing fingers.
This is a call to action to my physician colleagues.
Be angry. We’ve earned it. Be skeptical. We’ve earned that, too. Our profession has been taken advantage of and abused. But then, let’s take a step back, gather ourselves and begin moving forward.
It’s time for us to stand up and lead by example. Let us lead with patience, clarity, strong backs and integrity.
We can say no with dignity and grace.
We can move forward with strength and collaboration.
And above all — through our actions, our advocacy, our work and our words we can hold fast to our oath, to our promise to do no harm. No harm to our patients. No harm to each other. No harm to society. No harm to our profession. No harm to progress.
Let us rise.
Julie K. Gunther is a family physician and can be reached at Spark MD.
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