A Simple Answer by Patrick Conrad MD
For a laugh and/or hangover cure, I was on the couch this evening perusing the latest “Family Practice News” and voila!, it did not disappoint. Under “Policy & Practice”, I learned that the RAND Corp. did a recent study in conjunction with an AMA project “designed to identify the factors that influence physicians’ professional satisfaction.” The big bugaboo to job satisfaction noted was “current EHR technology” that interferes with patient interaction, makes doctors do too much clerical horse-hockey, and degrades the accuracy of medical records via a template mentality.
Doug and others speak out all the time to debunk studies made lousy over an agenda which presumes the results, so let me chime in…this project is C-R-A-P! How do I know?
The lead sentence for the article is: “Providing quality patient care drives physician satisfaction…” The summary sentence is: “Other sources of physician dissatisfaction include productivity quotas, limits on time spent with each patient, and overall workload.” Nowhere in the entire article does it mention money, cash, moolah, sawbucks, or any other remunerative term you might wish to employ. This is the AMA and its AAFP lapdog using RAND to tell us all that docs are selfless martyrs who only want to sacrifice themselves efficiently, with no thought of payment. They think they are cleverly misdirecting the public and their colleagues away from the real issue – $$$ – which will happen, one day, eventually, if we all just buck up and get on board with the team.
Well I’m calling BS. The AMA et al have pushed for years to achieve and further all the things leading to greater physician dissatisfaction, and EHR’s are right at the top of the list. We all live in an ICD/CPT, audit-misery, malpractice storm cloud, bitchy-patient world, with waves of P4P on the way. If our organized medicine masters and their data-crunch propagandists want the real skinny on how to increase MY satisfaction, here is a simple answer: more money. Go ahead and rag on my anger and cynicism over this if you like, but the fact is, I’m the one doing the work.
It’s simple, more oldsters like me are telling the youngsters to stay away from FP , IM, IM/peds. One has to be moron to go into primary care these days. Not a thing is going to change until people are held responsible for their shitty habits. I was trained to do the best I can with what the patient “allow me” to accomplish for them.
If they fail to follow my advice. I do the best I can to mop up the mess. I go home with no worries.
Obnoxious people, I fire or they leave on their own accord.
Outside of the “ROAD” specialties that Dr. Doug espouses (Radiology, Opthomalogy, Anesthesia or Radiology)
I think training as a “generalist” cardiologist is a good prospect. Hell, if one doesn’t get cancer, the heart is the next big thing to go. Can pawn off the diabetes to their “primary care” idiot who can’t get them to bring their sugar diary to the office. I’ve been told that cardiology fellows will have 5 job offers before they complete their last year.
Compensation is always important, though work load is crucial also. And obnoxious patients are an under-rated source of burn out, and have certainly put lots of gray hairs on my head.