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
Once the NPP’s start getting hit with malpractice suits, the idiots that promulgated this situation will be looked at as fools. Unfortunately patients will get hurt. I remember a PA that did a biopsy of a nevus and when it came back melanoma asked a surgeon, “How much more should he (the PA) remove.” Needless to say the surgeon took over the case and that PA was no longer employed.
The NPP’s are going to make more mistakes, there will be more lawsuits and in that case of independent practice, there’ll be no physician to throw under the bus. I retired last July 1st and am loving it.
Wow, just wow! I love what you wrote and embody that message every day with all the f*cks included. I hate what has become of our profession and healthcare in general. It no longer has anything to do with patient care and all those who act to further the system of ‘wealthcare’ have violated the Hippocratic oath. “First do no harm” has been flung out the window in the name of profit. Those who are administrator and supervisory physicians routinely eat their young.
I was personally chewed up and spat out by my alma mater after serving there for 30 years, medical school, two residencies/board certifications, fellowship training and a successful and highly respected career as an ER Radiologist. After seeking 2 days leave for my disabled child, being denied and taking the time off anyway, the chair who had it in for me for opposing her discriminatory activities and patient care failures, found a way to terminate my employment.
I litigated this against New York City and New York State for 6 years only to find that the Judges were complicit, deliberately misrepresenting the law and brazenly denying me a jury trial despite mountains of evidence. As a result I have been unable to find a daytime position as an ER Radiologist during a pandemic!
I loved my career, but hate what healthcare has become. Physicians have allowed their profession to be hijacked and are now suffering ‘moral injury’ at alarming rates while suicide rates climb. Frankly, I am ashamed and unfortunately it will have to get far, far worse for patients before the voting public gets their pitchforks out.
9 out 10 administrators, private equity groups and insurers need to get the f*ck out of healthcare now damn it! We need to be an organized woke group of professionals moving heaven and earth to get this done.
I love it and agree with every word, emotion and sentiment you have written. More power to you. Please let me know how I can help, I am willing to write, lead, take risks or take a bullet if necessary. Thats how important it is to me.
Thank you so much for putting my exact feelings in powerful words.
Oded Greenberg MD
These needs to be an OP-ED in the Washington Post/New York Times or picked up by Propublica. For us to discuss it amongst ourselves is just not enough!
It may work if you send it versus us
Well said Dr.Newman.
I hope your voice is not drowned out by jealousy,and the nasty competition that many physicians waged to get into med school.. Those OLD HABITS die hard. Get 2 physicians together and instant Fights and competition
begins.. You “Physicians” are your own worse enemies and Advocates. Not very good mentors either…
I am an expert as a PA-C OF 44 YEARS. I want to be #2 . and assist my physician supervisor by taking care of his routine cases while he devotes himself to more complicated cases.. AT LEAST THAT WAS HOW IT WAS SUPPOSED TO BE.. Yet most of my positions in Family Practice,Emergency Medicine,Urgent Care, I was a substitute MD/DO.. When I called for back up I was often told to transfer the patient, or ignored.. Since I documented the encounters with my supervising Physician. I did not get sued.. They or the Facility did..
Result being I got canned/ fired/ contract not renewed.. Don’t care,I did what was right to protect the Patient, Me and the Facility.. Loyalty should go both ways.. Seldom does it except in Fiction..
EVERYTHING IS COMPETITION and EVERYTHING IS A BUSINESS MODEL..
However I still love being a PA-C. I still study and read everyday..
Right now my spouse of 48 years is dying so I must care for her. When she has passed I will start looking for another position locums or permanent for another 6 or 7 years..Then I will fade away too.
I hope physicians can survive.. NURSE PRACTIONERS NOT SO MUCH.PA,s have always been around in Doctor offices and one way or another always will.. Just like Army Medic’s. Always been there always will.
Jesse, I want you to know I sincerely appreciate your many comments in this forum supporting the leadership of physicians. My sincere, heartfelt condolences…48 years. She had to have been an incredible woman. I will pray that you get through this Jesse. When you start looking for a job, let me know. I will do anything I can to help. We cannot afford to lose you. There is so much you have to offer.
So very sorry to hear this.
Bravo to every word, and nice ending!