I knew this day would come, when my survival would depend on my ability to reframe a covenant once made. Medicine, the knight in shining armor that has given me livelihood and legacy has taken so much. I willingly surrendered for the title of physician and the responsibility and privilege of being a healer. But relentlessly, Western medicine has tried to strip me of me so I would robotically serve him without resistance. It weaponized a hippocritical oath, a vow to do no harm. Then repetitively, it encouraged me to work in ways that were at times harming to myself … and others. In my heart and soul, I still have hope for this twisted union, that my goodwill win and we can go on symbiotically to do what we were called to do.
Western medicine, what have you become? You are single-minded while pretending to be wed to doctors, patients, lobbyists, lawyers, pharmaceutical companies, insurers, and regulatory committees that have painted the shape-shifting mask you now wear. Someone is bound to get hurt in this corporate polygamy you have constructed with its unclarified rules. That someone is likely the patients who need you most…and those who serve.
As a seasoned physician, I stand weary with my colleagues who have become scapegoats for a system that has helped many but failed more. The public believes that physician salaries drive up health care costs when it is actually the machine behind Western medicine that profits. Medical capitalism will never solve health care problems. Universal health care may, if it offers options, demands accountability, and forces the Western medicine machine to do something it has never done – open the books, show the receipts, and share.
My conscious is now painfully conscious. It is clear medical education needs an overhaul when trainees feel entitled to “learn” because of their level of personal and financial sacrifice. When did seeking care at a training institution mean surrendering rights? How many patients are coerced, bullied, experimented on because they feel powerless? How many hands have examined (assaulted) patients while under anesthesia? Do we reward the patients who respect us by asking that they allow trainees to interview and examine them when they clearly would rather not? Do we continue to abuse the young, minority, marginalized, or mentally ill by not even giving them a choice?
The unspoken truth is that those most responsible for taking care of the masses are themselves sick and suffering from disease. According to the American Psychiatry Association, physicians have the highest suicide rate of any profession 28 to 40 per 100,000 – a rate double that of the general population. Stress reduces life expectancy by an average of 2.8 years. We carry our stress with no adequate time or ways to unpack it, moving on an assembly line in 15-minute increments – processed productivity masquerading as care. If we dare to truly see our patients and to care for individuals the way they need and deserve, we often hear complaints about wait times from patients and administrators alike. Do we work … or heal?
The desire to heal sits like a primary tumor we have learned to live with. It seeds our lives like an aggressive malignancy if we fail to set personal, professional, and ethical boundaries. This is the energy we carry into exam rooms and down hospital halls. It is no wonder so many can’t get well.
Dearest medicine, you injure relationships and weaken health care teams by pitting physicians against nurses, mid-level practitioners, physician assistants, and others. You keep us in servitude with the threat of being replaced by someone you can get to work cheaper and according to your algorithms. Can wellness thrive in a system such as this?
And then came COVID-19, the world can finally see how much we need each other. Every able-bodied member of the team must work together if we are to survive. Do we, will we? This pandemic has tested our fortitude and the cracks in Western medicine are showing.
I wonder if anyone will come to help the physicians who serve. President Biden should offer a special healing package for them. Doctors carry enormous responsibility and emotional burdens and have paid some of the highest price-tags. When a decision is made regarding student loans, I hope he stops leaving out physicians because they are “high earners.” $50,000 debt elimination seems like a good number to start with, not as a reward but as an investment. It will be just enough for some of us to pay for the psychotherapy and substance rehabilitation we really need to go on in this relationship, to heal ourselves, to serve our patients, and to help repair a broken health care system with the love, strength, and faith that it truly requires.
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