“I don’t know what happened” is probably one of the most common phrases any parent hears. Last weekend, while wrapping my son’s bleeding head in gauze from our first aid kit, this was the best explanation my daughter could muster as to why her two-year-old brother was screaming, holding tightly to a blood-covered plastic ice cream cone. In the end, it was a complete accident (he hit his head on a desk while bending down to pick up said toy). And yet her first gut instinct was to deny, play the fool, and buy time.
Sounds like most of us when problems occur, doesn’t it?
It seems like the recurring headline on the evening news is a vague “Health Care is Broken! And researchers say it’s because of…” We are all so quick to point fingers. Doctors get paid too much. Nurses play cards all day. Administrators don’t know a patient from an ATM. Housekeeping staff is too slow. Damn EHRs! Big Pharma! And yet, with all these easy scapegoats, not one thing has changed to make our system better. In fact, many would argue, it’s only getting worse. I think the reason for that is simple:
It’s all your fault.
Who are you? Doesn’t matter. You could be a patient, a doctor or a health care administrator. You could be one of the hundred other players involved in delivering health care in this country. Doesn’t matter. We all have a role to play in the system we have.
Patients. You want convenience? You want to be seen right now? You want a pill for every problem? Guess what. Convenience comes at a cost. We need to pay doctors, nurses, technicians, registration workers, housekeeping staff, electricians and many other professionals to sit around waiting for you to arrive, just so that we can see you within five minutes of walking in our front door. And if you don’t feel like coming in right now? Too bad for you, health care. We still want you to wait for us when we do feel like coming in.
Nurses. While your unions fight for higher pay, you get leveled with more busy work that keeps you from what you really want: quality time with your patient. You became a nurse so that you can take care of patients in the most intimate, rewarding and humane way possible, only to be overburdened with EHRs that take you more time to navigate than it takes to run that diltiazem drip. Why do you put up with the administrative burden of your daily work? Is it because you’re too scared to speak up? What about that patient safety training you took last week? Speaking up saves lives! Save the lives of nurses, patients and this invaluable profession.
Doctors. Many of you have quit rather than stand up for yourselves. Those who survive bend over backward to the overwhelming burden placed upon them by administrators and insurance companies. Why would you order an MRI for the patient with a possible soft-tissue injury to the neck? Aren’t CTs even cheaper and faster?
Heck, an X-ray takes seconds to perform and costs pennies-to-the-dollar compared to that MRI you want. Meaningful use! Meaning: put our money to good use — patient be damned. You studied for decades to practice medicine; do what you can to preserve your profession.
Administrators. Listen to your doctors, nurses, technicians, and allied health professionals. If they’re not talking (because of intimidation or fear of retaliation), just ask them! You may understand profit, business, and finance, but they understand patient care, health, wellness, and how to really care for the sick and injured. Recognize that, in this arena, you are not the content expert. Ask for input and feedback from your clinical staff. They’ll give you perspective on what they need, and don’t need, from you.
Insurance companies. Pay for your patient’s care. You got into the business of paying other people’s bills, not the business of manipulating doctors from the outside. Why is it that a doctor could get in legal trouble for a curbside consult that goes south, but not an insurance company that denies a test that results in misdiagnosis or delayed care? Oh, and, I’m sorry, but having your staff pediatrician talk to the trauma surgeon about a denied service is not a “peer-to-peer consult,” it’s a peer-to-peer insult. Every delay, every unnecessary consult, every phone call makes the system more expensive. By trying to save a buck, you end up wasting hundreds more.
Big Pharma. Be real with us. How much does that drug actually cost? Is it really better than current treatments? Are the side effects truly as benign as you say they are, or are we going to discover some deep, dark, morbid secret 10 years from now? If you truly need better funding, tell us. Maybe the research and development process can be streamlined at the federal level. Until you become more open with the rest of the health care industry, you’ll continue to be lambasted by the news media as the “evil” entity you are, despite all the good your products have done for humanity across the globe.
There are many, many more subsets of people I can call out. But, at the end of the day, we all need to realize that we can only take responsibility for things within our circle of influence. I can’t change patients, nurses, doctors, administrators, insurance companies, Big Pharma or anyone else. I can look at the role I play in this system and take responsibility for my actions. Then, and only then, can we begin to make a change.
Hi, I’m an anonymous health care worker. The flaws in our system are my fault. I’m sorry. Let me figure out how I can make my part of it work a little bit better.
The author is an anonymous medical student.
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