Medicine as a Team Sport

aaaasss

If you haven’t noticed, the trend has been to remove power and responsibility from doctors. Why?  There are not enough of them and they are too expensive.  This is a money game.  So if you were in charge of this type of problem then what plan would you come up with?  Well, bring in less expensive workers and call it a team.  Sounds nice.  And doctors buy into crap like this.  “You mean others will do my work and I get to sit back and just check on them?”  Yup.  For a while.  But then you lose credibility.  The patients don’t see you and the people who pay you wonder how to get rid of you.  Does this all sound familiar?  Oh, you can name it teamwork or patient centered medical home or accountable care organizations or anything else.  It is a brilliant plan to separate the patients from the doctors in order to get rid of the doctors or pay them less.  Here is proof. Here is an article in the NY Post called When a nurse is your health-care provider, you’re at risk. It is a good read and on the money.  I would say that the title is inflammatory and that doesn’t help but that is what happens in turf wars.  Anyway, I am sure the NPs are going crazy over this.  Picture a red ant hill being stepped on.  Doctors, though, are to blame for this.  We gave up control, probably to make more money, and now we are all paying for it.   Anyway, back to my point. Now we are being seduced into the “team” game.  Well, we shouldn’t.  When Mike Sevilla MD, linked this article to his Facebook page, the red ants went crazy there too.  Here is one patient responding:

My child’s NP has spent ten times more time treating my children than the MD “supervising” her. His only contribution: approving the prescriptions she writes. The only risk I feel here is to his wallet, and that is one I can live with.

You want to be leader of the team?  Great.  You want to sign off on NPs or PAs all day?  Wonderful. You want to be medical director and see less patients?  Fine.  But you lose the respect of the patients and they will turn on you.  And they will turn on all of us doctors.