A physician recently recalled to me a situation he found himself in on the last National Doctors’ Day. Those of you reading who work in health care, will already be aware that this is on March 30th every year. I have seen this day celebrated in every hospital I’ve worked in since I first came to the United States over a decade ago. I actually think it’s a nice gesture, and always good to reinforce appreciation for any dedicated group of professionals — whether they be physicians, nurses, pharmacists or physical therapists.
This physician works in a busy office next to a large hospital, and knew that there were treats laid out in a special conference room. He had received a correspondence inviting him to pop over during the day, to get some food and snacks, to celebrate the occasion. He was extremely busy in clinic that morning but did find some time to head over for a few minutes during his lunch break. As he recounted to me, he walked into the room, only to find that there wasn’t a single other physician in there! Instead, there were a number of administrators — many of them in their 20s and 30s — all helping themselves to lunch, cakes, ice-cream and sodas. He was a bit surprised, as he expected it to be a collegial scene, where he would get to bump into some of his physician colleagues that he rarely gets time to interact with anymore.
Perhaps he had just gone in at a unique time slot and missed all his medical colleagues (although it was peak lunch time). Maybe hundreds of physicians all walked in together 5 minutes after he left (unlikely). But let that scene sink in for a moment, because it’s emblematic: National Doctors’ Celebration Day. Not a single physician in sight. All of them probably busy on the floors, seeing patients, or having to perform data-entry tasks on computers.
Several months ago, I wrote an article about a chart that speaks a thousand words. It shows the dramatic explosion of administrators versus physicians over the last 30 years. I also wrote an article about how the demise of the physicians’ lounge represents the demise of the profession, a piece that went somewhat viral within the physician community. The dramatic loss of autonomy within the medical profession over the last 20 years, and the exponential increase in bureaucracy, is a major in-your-face reason why our health care system is in trouble with uncontrollable costs. It’s not that health care administrators are bad people—I know many professionals who work in administration — and they are perfectly fine people. Of course, as in any industry, a certain number of administrators will always be needed. They are in a way, also victims of the mess we are in, having to do mind-numbing tasks that would unlikely be needed in a dramatically simplified system. Somewhere in health care, we have gone badly wrong, and are at a place where the cart now so often drives the horse.
But for now, I’d just like you to keep picturing that scene. That conference room celebration on National Doctors’ Day. Devoid of any physicians.
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