Hard Times


The article in Forbes entitled Why This Is The Hardest Of Times To Be A Physician In America is worth the read though I think I see where it is headed.  This is second of three installments by a Robert Pearl MD who is the CEO of The Permanente Medical Group, a certified plastic and reconstructive surgeon, and Stanford University professor.  Boy, he has a lot of titles but, alas, none of them are really applicable to those docs in the trenches.  Sorry, dude. That being said, here are some nuggets from this piece:

  • And given the recently announced mergers of the largest insurance companies into three mega-giants, we can expect this process to continue. Increasingly, we are seeing this approach take an adverse effect on patient care and physician satisfaction. And when doctors complain that these payments fail to cover even their office expenses, insurers threaten to exclude them from their company’s increasingly narrow networks. Already insurance companies prohibit about one-third of providers from participating in the state health care exchanges.
  • And being prevented from providing the right therapeutic option is frustrating and exhausting for physicians, particularly when they read that the insurance company used 15% or 20% of the patient’s premium for administrative expenses and return to shareholders.
  • Entering and retrieving information via EHR can take a physician inordinate time compared to entering the information in a paper medical record. And the high number of clicks required, even for relatively simple problems makes many physicians feel like data-entry clerks. Combining the added time to document with the need to see more patients a day, physicians are acutely aware of how much less time they now have with their families and each of their patients.
  • Were the government to run our health care system through a single payer, the inevitable red tape and politicization would be disastrous.
  • And selling your practice to a hospital or insurance system, which many doctors have embraced. proves even more frustrating for most as the demands imposed by these institutions once the deal is done more than offset the short-term advantages.
  • So what can be done? Already there are organizations like the Mayo Clinic, Kaiser Permanente and Geisenger Clinic that have overcome many of these problems and improved the lives of both patients and physicians as a result.

He does explain what is killing us doctors today.  I will give him that. He had me going and hooked for awhile until the last part.  That is when he started praising the “employers” of doctors in the last bullet point I give and he is doing that because he is an administrator who employs doctors. So, let’s see where this goes in part three. I would amazed if he mentions direct primary care.

(Had to put the Charles Bronson poster as the image.  Who doesn’t love Charles Bronson?)

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