Catatonia–The Siren Song of Unwoke Physicians

Dear catatonic colleagues…what can those of us who are “‘woke” do to wake your a**es up from the coma of chronic acceptance of degradation, diminution and invasion of our profession? Everyone and their pet dog are conflating themselves with physicians. While you keep babbling about “integrative, collaborative teams”, corporate medicine and non-physician practitioners(NPPs) promote “independence”, which includes none of that. While you continuously blather that NPPs are an integral part of the health care team, they make it clear that physicians are not only NOT wanted on the team, we are no longer needed because they can now do what we do. Do you not understand that is what Full Practice Authority(FPA) and Optimal Team Practice(OTP) is about? We are criticized as being arrogant for having the audacity to expect to be referred to by our appropriate title, “Doctor”. How dare we? They don’t want us to be identifiable because we expose the pretense. They don’t want truth and transparency, they want fiction and opacity. We are expected to lift them up while they put us down. Corporate medicine, who has no respect for any of us health care professionals, identifies all of us by a dehumanizing term typically used in business. Physicians, in your vacuous state, embrace the offensive label warmly so the charlatans don’t feel left out. How is it that physicians, some of the most intelligent human beings on earth, can remain such passive, accepting puppets to mistreatment? Gluttons for punishment is an understatement.

Do none of you see the absurdity of NPPs who were trained by physicians now purporting to do what we do, despite the fact that their medical training is either abbreviated or non-existent? They have no appreciation for our expertise or how imperative the fundamentals and foundation of medicine is to our practice; they only have contempt for us. They envisioned that we would step aside graciously and quietly while they spouted that bulls**t of them being equivalent. F**k the medical students doing it right. F**k the residents putting in the work. They expect us to focus on them and forget about our oath to the students/residents to whom we are expected to hand the torch. Their scorn for them is unsettling because it borders on pathologic. What is worse is you attendings who allow the degradation of these students because you also believe they are arrogant, when in actuality they are demoralized and continually subjugated to abuse. Afraid to speak up for themselves because they have no advocates, save for the few physicians who have a conscience and still possess some humanity and testicular fortitude. Physicians have the highest suicide rate of all professions and we do nothing to protect or save our own or the House of Medicine. Not a f***ing thing. We not only permit the maltreatment, we engage in it. And when we are not abusing these students/residents, we act as if they don’t exist. Physicians exhibit the worst form of self-hatred by how we treat our own. We don’t even treat each other as if we are a part of the team. Google “physician advocacy groups” and take note of what pops up. You will see malpractice attorneys who, in a way, are advocates–when we get sued. However, this is not to what I am referring. Mostly you will see groups that affect local or national policy regarding physicians as a whole and/or protect the patient and physician relationship. Yes, those are important, but where are the ones strictly for docs, interested in their well-being as human beings? Where? There aren’t any. This is tragic. We advocate for others’ well-being but not our own? We simply don’t know how to fight for ourselves and stand up when we see wrong being done to each other, as well as physicians-in-training. How many of us have reached out to a colleague who was terminated unfairly and asked how he/she is doing? Tried to find them help getting another job? Showed them support instead of disdain? We’ve been so conditioned to despise each other that we allow ourselves to be disparaged by those HCPs who take umbrage at our very presence. Yet we are more supportive of these offenders while they continue to devalue us. They are so comfortable that entire, so-called “professional” umbrella organizations confidently publish statements that are defamatory to physicians and they demonstrate no remorse in the slightest. Still, physicians continue to regurgitate the importance of “the team”, endorsing individuals who should be on no team, because they are disruptive and toxic. It should not be necessary for me to state that I do not believe all NPPs engage in this miscreantic behavior. Nothing is absolute. But those who say and do nothing about the blatant disrespect against physicians are complicit in their silence, regardless of their reasons for remaining silent.

The House of Medicine is under attack–make no mistake about it. By private-equity backed corporations who see the profitability in sickness, by opportunistic, sellout physicians seeking prestige and money and idealistic, predatory NPPs whose desire it is to usurp the role of physicians without putting in the actual work required to become physicians–because they don’t want to. Do not be fooled by the euphemistic statements  of “modernization” or the “future of medicine”, implying that by not conforming one is lagging in progress and needs to get with the program. F**k the program. The practice of medicine progresses naturally, that is why patients are living longer. It is self-modernizing; however, the incentive was to improve patient outcomes, not line the pockets of shareholders and appease rapacious NPPs, physicians and corporate executives. We don’t need corporate medicine’s interference, we need them to be terminated. Permanently. Do not be swayed by the gaslighting that accuses physicians of being pompous and engaging in a “turf war”. MEDICINE!!!!!! IS!!!!!!!! OUR!!!!! TURF!! Period. We are the only ones educated, trained and licensed to practice it. That cannot be disputed. A basketball player cannot go onto a football field, demand everyone play basketball then have a tantrum when he/she is told to get the f**k off the field. He/she needs to stay in his/her lane and that lane ain’t football, it’s basketball. That is where he/she excels, so why meander onto a field where one does not possess the skills to participate, simply because one perceives there is a bigger audience, wishes to gain more attention or wants to impersonate a football player? Wanna play football? Then do the training required to become a talented football player. Why is this so f***ing difficult to understand? And if one cannot play basketball or football, take up golf where there is plenty of turf.

“Many pretend to despise and belittle that which is beyond their reach.”― Rory Sutherland, Alchemy: The Dark Art and Curious Science of Creating Magic in Brands, Business, and Life