The Seven Sins of our Medical Leaders
In the latest AAFP Family Practice Management comes an attempt by Aaron Garmin, MD to modernize a 1948 article called the “The Seven Sins of Medicine”. Obviously, the original was a play on the seven deadly sins and this one is a play on that one. Anyway, I can just see this doc racking his brain to figure how these sins might apply in today’s environment but do it in a nice way so it gets published. Hooray, he did so now let’s trash it.
Garmin had a shot to really make some great points about “industrialized medicine” but he missed the mark completely. Don’t get me wrong, it’s not that some of his stuff doesn’t have a point but remember the title, SEVEN SINS OF MEDICINE as he relates it to TODAY’S ENVIRONMENT.
Here was his:
- Not communicating with leadership.
- Not putting patients at the center of care.
- Not building relationships with our team.
- Not practicing evidence-based medicine.
- Not investing in care coordination.
- Not using common sense.
- Not letting others help us.
Talk about your politically correct, ass kissing, drippy, and wimpy list. Dude, grow a backbone! With all that is wrong with modern medicine, these were your issues?
Let me help him name some sins and there are plenty more than seven:
- Not taking over the business of medicine and letting others do it for u.
- Approving the Affordable Care Act!
- Approving PCMH, ACO, and other initiatives.
- Buying into meaningful use.
- Not looking away from the EMR while with a patient.
- Treating patients as numbers and not people.
- Working for hospitals and getting treated like pawns by administrators
- Approving of Medicare!
- Following unproven quality metrics.
- Not fighting back against insurance companies
Please, feel free to add more and spread this around so somehow good, old Dr. Garmin gets a clue and stop being a wuss.
#14 Getting handed a bowl of alphabet vomit and then asking, “Please Sir, May I have some more?”
The deadly sin that started this crap sandwich was Envy;pure distilled envy given full force via the sanctimonious legal bureaucrats: “Doctors have too much power.” “Doctors don’t respect nurses. . .don’t respect patients. . make too much money. . yada,yada.” Unfortunately, the payment codes, performance evaluations, peer reviews, and ” jump through hoops” recertification have been constructed by these desk jockeys, aided by our fellow physicians who continue to feed this Envy Monster.
Doug, you ought to email the guy what you think of his drivel. Kurt
I don’t have his email address
“The real reason for all this trying to “fix healthcare” is about how to “fix” healthcare so as to squeeze every possible penny out of it for the stakeholders’ bottom line.”
I agree. The stakeholders do not include the doctors or the patients. They get in the way. Healthcare has lost its true purpose.
#13 allowing midlevels to siphon away our authority, respect, money, et cetera (and i’m talking to all the specialists with 3 PA’s working for them. we don’t send someone to a specialist for a PA’s opinion on something. wikipedia is often just as good.)
You can now see what they have done to teachers in public schools. Some of the things they tell you is an insult to your intelligence and integrity, then some of it is that if you do one command it contradicts another dictum. No more professional to professional approach. That does not mean that there are not bad apples that need to be kicked out, but it does mean that treating all professionals as if they were is offensive. I felt like I worked under a slave and master regime.
First they came for the Socialists, and I did not speak out—
Because I was not a Socialist.
Then they came for the Trade Unionists, and I did not speak out—
Because I was not a Trade Unionist.
Then they came for the Jews, and I did not speak out—
Because I was not a Jew.
Then they came for me—and there was no one left to speak for me.
Martin Niemöller
Wall Street has come for physicians
# 12 Not refusing to to treat medical malpractice lawyers.
#13. The population is more important than the patient.
Why? Why is it that the medical world keeps trying to figure out how to practice medicine? Is the art of medicine not good enough? Are the technical, medical advancements not an improvement? Does not the education that a doctor acquirers not good enough to practice medicine? What the Hell is all this trying to figure out how to practice medicine for? It’s not that doctors don’t know how to provide medicine… and it’s not that the patients don’t want them to… That worked when practiced. No, it’s got to be something else, because if that was what the motive was here, that isn’t so hard to just let doctors be doctors and treat their patients. That is the obvious real answer but that is Not what this about. The real reason for all this trying to “fix healthcare” is about how to “fix” healthcare so as to squeeze every possible penny out of it for the stakeholders’ bottom line. That’s why all of this fiasco won’t ever be resolved because too many people really think it’s about “fixing healthcare”. The confusion will go away when they call it what it really is, the conversion of American healthcare to big profit making “Toyota Assembly Line Medicine”. And all patients, doctors and medical staff will have to be controlled to make it work the way the Executives want it to. #BigMed #LetDoctorsBeDoctors
Dr. Garmin obviously does not want to be considered a disruptive doctor.
To translate out of Newspeak:
Every team member has a vote on the medical care of the patient – but only one bears the blame.
Yup.
#12. “Responsibility is delegated without the means to achieve it.”
I was banging my head against the wall on Friday, trying to “gain consensus” that a HbA1c of 8.8 required aggressive action. No, said the Team – it was Better. Sail on into substandard care, hold your course!
BTW, when the performance metrics come around, whom do you think takes the rap for bad diabetes control?
The story is a renunciation of the children’s fairytale about the Little Red Hen. Lie around when the work’s being done, and give advice – that makes you a Team Member!
http://www.enchantedlearning.com/stories/fairytale/littleredhen/story/
#11: Peer review is the evil antithesis of mentorship.