THE BLAME GAME….WHO TO NAME?
It has become so easy to blame physicians for all the wrongs that are occurring in health care. And it is unfair. So let me clarify some things.
Medical school and residency taught us how to care for the human body and all of its requisite ills. It did not prepare us for the onslaught of HMOs and the corporatization of medicine. Containing costs while maintaining quality of care appeared to be a good idea, wouldn’t you agree? Well, as we are now aware, treating medicine like a business resulted in a disaster because health care became a billion dollar INDUSTRY. Turns out it was never designed for quality or health care, it was designed to make a profit. The public became the commodities. Physicians became the grocery store employees responsible for processing these products expeditiously. You know. Like cattle. Get ’em in, get ’em out. More patients, more money. Since physicians represent the face of medicine, it is easy to blame us for this travesty.
Ever notice in all of these discussions no one ever hears from the health insurance companies? Ever wonder why? While we are all fighting and blaming doctors, they keep raking in the dough. Laughing. They arbitrarily raise insurance premiums for any reason. The ACA didn’t create that mess. It existed before President Obama was even a Senator. Did any of you contact your insurance company and ask why they increased your premiums when the ACA was still being discussed or after it was instituted? I certainly did, when my company notified me of the impending increase. Their reason? In ANTICIPATION of expected costs, they raised my premium. Now let’s get this straight. They raised my premium, in advance, in anticipation of an event that had not yet occurred. Not because they had to. But because they could. There was and is no law against them raising premiums. Blaming the ACA was both a convenience and a distraction and it worked. How about holding them accountable for a change? Write letters to the CEOs and ask why they keep increasing your premiums unnecessarily? Nope, just keep blaming physicians for the rising cost of health care, despite the fact that our pay represents perhaps 10-20% of healthcare spending. But who cares about facts? https://www.forbes.com/…/debunking-myths-physicians…/…
Physicians have the highest suicide rate of all professions in the United States. Higher than the military. Approximately 400 docs a year leave this earth by their own hand. An entire medical school per year. The actual number is probably higher, but these are the reported ones. You see, docs don’t talk about depression too much, the medical board who grants us our licenses sees that as a weakness and a reason to suspend one’s license. Without a license docs cannot make a living. Which makes them more depressed. And most likely adds to the suicide rate. The perception of the public is that we are “prima donnas” who think we are better than anyone else. Quite the opposite. Our industry makes sure we understand that we are not valued by them as human beings. It is our licenses they need, not us. Businesses cannot dictate how physicians practice medicine, it is illegal. Physicians dictate medical care. But here’s a secret between you and I. The corporations do it anyway–by proxy. Sadly, many of my colleagues perpetuate this “fast food” medicine racket. Some for the few extra dollars they may make as an administrator. Others out of fear that by not doing so, they will become unemployed. The health industry is one of the most toxic places one can work. Physicians can be fired at will, without due process. It is against the law for us to unionize. We work overtime for no overtime pay. Zilch. We do not get administrative pay. Those charts your doc has to complete at night at home while trying to eat dinner with the family? No pay for that time. Nada. And to top it all off we continue to care for patients who spit, curse, threaten, assault, etc. Put simply, being a doc isn’t all peaches and cream. And those conditions can lead to depression, which we are also blamed. One might then ask, why do we stay? For the one patient whose life may be saved by our intervention. For the one vet who holds your hand and cries because you gave a damn. For the one child you can hand back to the parents healthy and happy. For the one patient who says thank you instead of f*** you. That’s why.
The years we doctors spend during and after college practically destitute to become physicians is worth every dime they currently earn, whatever it happens to be. We chose to pursue excellence and there is a price to be paid when achieving that goal. We paid it. And for that choice, we happily accept the blame. However, I will never apologize for the amount of money I make. No one determines my worth but me. Everything I have accomplished is in honor of my parents who did not have the opportunities I was provided. As a physician, I took a Hippocratic Oath. I did not take an oath of poverty. That would be Mother Teresa.
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Few, if any, rival the disgust which the American culture shows for humanity. Fallibility, imperfection and many other very human attributes, are condemned categorically. Inhuman entities; governments, corporations, bureaucracies-whatever acts by rules and algorithms-are treated with fondness and trust. We are helots by choice, to the Spartan machines. But even the arrogant Spartans were human. We lust for a future but as slaves to the mechanical AI masters, forgetting that they are but unthinking crafts of our own hands and minds. We seem to despise each others’ humanness. The end is deterministic and pitiful.
You made a lot of fantastic points, but I did not see calling out the greatest perp of all: government, and the patients (and docs) who ceded rule of health care to them.
For all the great, very real evils done by Big Insurance, they still do not equal the harm done to medicine by Medicare/Medicaid, the only insurance payers whose edicts and audits are backed by guns. Until we squarely stand against the poisonous notion of healthcare a a “right”, we will accelerate down the path toward single-payer. Every harm done to physicians by Big Insurance may be doubly done by the CMS overlords who can define “quality” by fiat, as an excuse to yet again not pay formwork already done. It is patients that demand we be controlled by government, encouraged by doctors betraying their profession in 1965 by accepting Medicare. Do not neglect this greatest disease.
Point taken. There are certainly many more with whom the blame can be shared. Unfortunately, could not fit all in my commentary. I would have a book and not a blog.?
I may have been accused of that on occasion ?