Being the Doctor Your Patient Wants
“And all you have to do is be the kind of physician your patient is hoping you will be.”
Easier said then done. The industrialized medicine model makes it very hard. Doctors need to care (most really do) plus they need time. It’s that second piece that is so elusive. That is why doctors become indifferent. Add to this the bureaucratic drag and you have this massive recipe for disaster. I know. I was there. Fortunately, I now do direct primary care and I have time, I have no boss, I have minimal bureaucracy and I think that I am the physician the patients hoped I’d be. This story in the NY Times is just academic fluff that means nothing unless the system gets fixed. Trust me, no bullshit Press Ganey score will accomplish that.
“Suffering”, like …
-the constant, growing burden to do more minutiae in less time?
– docs and hospitals fighting with CMS directives eg. re-admission penalties that would be schizophrenic were they not so clearly aimed at payment reduction/denial?
– tight private docs barely able to make payroll, socked with new EHR mandates, moonlighting on weekends just to pay their own bills?
– the always present threat of malpractice?
– the sure knowledge that one’s lobbying and advocacy rep’s are cheerfully selling their clients out?
This hit piece almost read like a parody, with the usual elite northeastern doctors and their sympathetic media crank out another verse of “Yes, we are the problem! Please tell us patients, how may we further abase ourselves for you?”
I expect most doctors could be the doctor their patients want if they weren’t wasting so much time being the doctors our government wants.
If I was the kind of doctor that some patients wanted me to be, I would be running a narcotic pill mill, would be a public health menace by prescribing gorillacillins for viral upper respiratory infections and would willy-nilly run up medical costs by ordering MRIs at the first onset of every little back twinge.
Mr Selridge was wrong, the customer is not always right.
… And guess who’s the first poster to come up in the “Picks” section of the comments, Doug (as of this moment, anyway)?
I will note for other readers here, a study released by the US Army War College this month, “Lying to Ourselves: Dishonesty in the Army Profession” (http://www.strategicstudiesinstitute.army.mil/pubs/download.cfm?q=1250), which documents how a huge number of mandatory, but physically impossible requirements (more mandated training sessions than there are days to train, etc.) leads to officers all the way up the chain of command flat-out lying about having completed them.
Sound familiar?
It is embarrassing how much the world is shaping itself into Ayn Rand’s dystopia, but as she observed, everyone must be made a liar, to feel guilty, to fear being unmasked – this is the precondition of building a totalitarian societies on men’s backs.
To be honest and brave is to raise suspicions – yes, you can be ground down like the rest, but you can never be made ashamed of yourself. Not only am I a keen critic of medical care well-done; I am a provider of excellence. I know it from my patients – not by going to national conventions and paneling my office with beautiful pronouncements and accolades and awards.
To heap one’s CV on lies and half-truths, that is the way to success in the Great World. The game has gone on throughout human civilization. I would rather be on the side of the few who pull it forward, rather than the many who drive civilization backwards.
American Medicine is merely a tiny shard of the greater problem. Our people do not call each other to excellence; we drag each other down to mediocrity, and smirk at the evidence of our efforts in the harm we can produce.
That is the culture of the lie. It is so pervasive, it is like trying to explain water to the fish or air to the bird.