Best of Authentic Medicine: You Are Not Special
Welcome, Doctor, to our medical community! It is good to have you here. We rolled out the red carpet for your initial interview. Now, it is time to get to work. You are obviously very special!
Except, you aren’t…..
We have some big medical systems in this town.
We have many big practices in all specialties. Most are owned by either the hospital system or one of several large national corporations. Does that make you feel a little… uh… small? It should.
We have a few small independent practices, but not as many as we used to. Bless their little hearts!
You will, hopefully, work hard and prosper. Your patients will respect you and value you, so long as you participate in their insurance.
You may find yourself appointed to special management committees. You may even be asked to be on the board of the hospital or one of the many corporately owned healthcare facilities.
You will strive to do the right thing for the people of this large community. You may even feel you will serve as the conscience for responsible medical care in this region. But, let us not get too carried away here. If you find yourself in a leadership position as a physician, you are a mere figurehead. You are not here to cause trouble. You are not here to bring up inconvenient and awkward issues. The corporate leaders will listen to your concerns with solemn faces and then chuckle at your silly analysis when the meeting is over and you’ve left the room. You are mere decoration. You are in a position of leadership to simply add a veneer of legitimacy. No one really wants to hear you talk. They don’t want to listen to your issues about potential patient harm.
No! They want to make money and they don’t want you to stand in the way. If you are really, really good, we might even pay you a b
True, occasionally some of these doctors will take themselves too seriously and forget their expendability. No problem. We deal with it quickly and soon nobody even remembers who they were.
So, know where you rate. You are a bright and ambitious doctor. I could see you on our hospital board someday.
But just remember: You are there to agree. You are not there to change the world.”
So, let us summarize. Repeat after me:
“I am expendable.”
“If I quit or am terminated, nobody will miss me.”
“I can be replaced with a physician extender if I cause too much trouble.”
“I will keep my head down.”
“Healthcare executives know more than me.”
Excellent! That wasn’t so hard, was it?
it of a salary for being a “team player.” But, please don’t bring up awkward staffing issues. Remember, we got rid of doctors before you and we will do it again. Most were replaced with “physician extenders.” Your employer can do that to you, too. It would happen in an instant. Few patients would even notice.
But don’t despair. We do keep a number of doctors in leadership positions. They make good money. They are carefully chosen because they are malleable. They are savvy, too. They know who is paying their salary and it is way more than they made seeing patients. You, too, could reach such a position if you are really good.
Yes indeed.Midland, Texas, 2003/4 time frame.Cardiologist who had his own practice,hospital CV Surgeon 20 beds was charged for Medicare fraud.. They the FBI promised not to put his wife in Jail if he copped to a plea and 3 yrs in jail.His attorney was not very good,there was entrapment and a sleeper informant in his practice Took them 4 years but they got him.His practice and hospital was shut down.He went to the slammer for 1 year with 2 yrs probation.. No his wife was not charged. That was local Hospital and the FEDS colluding to get him.. He was and still is an outstanding who taught me a lot about Cardiology during the 16 months or so I worked for him.A very good Mentor. All his patients loved him and sometimes when others said it was hopeless,he gave people some hope and extra good years.. Hell of a good Man and Physician.Screwed by the powers that be in Midland,Texas.