The Absurdity of Modernity
The health care system is a mess. A veritable disaster. Caused by a fungating, parasitic corporate medicine mass that continues to progress and create more toxic destruction along the way. Sadly, apathetic physicians hesitate to move forward, with the expected, inevitable collapse of our House of Medicine looming on the horizon. They wearily shuffle along anyway, in a state of learned helplessness, unable(and/or unwilling) to redirect their focus because they believe nothing will change, regardless of their efforts. So they make none. Mark Lopatin, MD aptly described this condition in a recent op-ed(https://www.echo-pilot.com/story/opinion/2021/06/06/op-ed-physicians-need-shake-off-apathy-and-advocate/7508892002/).
Medicine is an art and a science. To learn how to manage an organism as incredibly complex as the human body requires significant education and training. No one should have to ask why, it’s apparent. The human organism, by its very nature, is in a constant state of flux, affected by internal and external mechanisms that necessitates one possess an ability to adjust to that fluidity–cognitively. It is exactly why algorithmic medicine should not be a thing. It is why the required groundwork of science education begins in college, which represents the basic building blocks of what will subsequently become the solid foundation of medical school upon which our residency and clinical practices are firmly assembled. And we traverse this training and educational path for years because it isn’t enough to simply memorize, we must KNOW and we must UNDERSTAND that which we practice, at a very fundamental, organic level. It is this arduous preparation that enables us to construct a House of Medicine as sturdy as concrete and as pliable as rubber. Algorithms, criteria, guidelines, recommendations, etc., all have a place in medicine; however, they are not laws and should not be used as wheelchairs to carry our a**es along whilst we relinquish our brains to nothingness.
But that is exactly what we have done…abdicated our intelligence and common sense to irrationality. So much so that we permit private equity-backed corporate medicine, which doesn’t know jack s**t about medicine but a hell of a lot about business, to control the narrative. We allow them to convince us that nurses with master’s degrees can practice as physicians. We then lend credence to this nonsense by regurgitating the rhetoric that since they have been nurses long enough(whatever long enough is), surely they can segué into medicine, because their subjective assessment of their own abilities is sufficient and valid enough for us to agree. Hmmm….Nope. The fact that NPs have no formal training in medicine causes some docs no concern whatsoever, the irony being that we are people who are actually formally trained in medicine. So we are willingly bamboozled. Ingratiatingly hoodwinked. The fact that NP curriculums are nothing like our programs simply doesn’t register, due to our self-imposed brain fog. By golly, if the American Association of Nurse Practitioners(AANP) says so, it must be. And when they spout their debunked, poorly done POS studies as “evidence”, not one brain-challenged physician takes the time to review that garbage. We simply take the words of nurse practitioners who consider themselves equivalent to physicians. We never ask the basic, logical questions of how is it possible for UNSUPERVISED nurses, who are not physicians, to have similar clinical outcomes as physicians when they HAVE NO FORMAL MEDICAL EDUCATION OR TRAINING?! How is it possible for NPs, trained by physicians in an apprenticeship model, to be considered “experts” after a random number of months because they were trained by physicians? Especially when it took those same physicians a minimum of 7 years to become the experts they are? How is it possible that any physician believes that he/she is so exceptional that he/she can completely bypass medical education and training and teach a nurse to be as highly qualified as a physician, with no NATIONALLY standardized training or competency exams? How is it possible that some NPs have the unmitigated gall to demand pay parity because they supposedly provide care “comparable to physicians”. Says who? Logic does not prevail here folks. The fact is, none of this is or should be possible because it’s ludicrous. The entire concept of “independent practice” for NPPs is a farce that has taken on a life of its own. Fiction becoming fact. And docs, some of the most intelligent beings on Earth, not only believe this s**t, they endorse it.
Now the physician assistants(PAs)have jumped on this bandwagon of preposterousness with their “Physician Associate” bulls**t. Arbitrarily proclaiming themselves experts in medicine if they have practiced as a PA, for whatever indiscriminate number of years they have alone determined is adequate. Apparently, since it’s what they think, it must therefore be true. Great objective litmus test. And their weak a** excuse for removal the term “Assistant” is that it resulted in them being confused with medical assistants. Yet, the fact that “Associate” may now confuse them with physicians causes them no consternation at all–because this is exactly what they wanted. The conflation. The fabrication. The embellishment. THE LIE. They are at peace with the deception. Normalization of deviance. The irony is that if nurse practitioners and physician assistants practice the same as physicians, then why the hell do some go on to medical school and residency? For what purpose? Because they crave redundancy? Because they possess an overwhelming desire to go into astronomical debt? If it doesn’t make sense folks, it’s bulls**t.
All of this idiocy is rationalized under the all-inclusive, rhetorical umbrella that this is “the way medicine is going”. That it is progressing and becoming more “modernized”, as if we have no choice in the matter. Let me make it clear, in no uncertain terms, that there is nothing progressive or modern about this psychotic madness. We do have a choice to not perpetuate this insanity. It is regressive, reckless, diabolical, dangerous propaganda that is finding success because our mental flaccidity enables our conforming and not resisting. Our learned helplessness provides us an unacceptable excuse to do nothing, be nothing and affect nothing. Medicine cannot progress without physicians. Period. This deranged health care system in which we practice is not how we learned medicine nor does it represent modern, authentic, humane medicine. It is the absurdity of modernity. When will we stop subscribing to this foolishness, shake off the mental lethargy, cease being acquiescent and reclaim our position as the leaders in medicine? My dear colleagues, it does not have to be this way. Medicine is our domain. That is where our greatest strength lies–in our expertise. In our mastery of the art of medicine. This is our narrative to tell, no one else’s. We own the license that is essential for employers to function and which NPPs covet, without either accepting the liabilities that accompany it or doing the work it took to earn it. Well s**t…we giveth and we sure as f**k can taketh away. So why don’t we?
“To be in hell is to drift; to be in heaven is to steer.”― George Bernard Shaw
Natalie, your eloquence leaves me breathless.
I appreciate that. Thank you.
Amen