Thursday, May 8, 2014

The misery of healthcare

Excerpted from “How Being a Doctor Became the Most Miserable Profession,” The Daily Beast commentary by Daniela Drake, MD, MBA, April 14, 2014 — By the end of this year, it’s estimated that 300 physicians will commit suicide. While depression amongst physicians is not new—a few years back, it was named the second-most suicidal occupation—the level of sheer unhappiness amongst physicians is on the rise. Simply put, being a doctor has become a miserable and humiliating undertaking.

Not surprisingly, many doctors want out. In fact, physicians are so bummed out that 9 out of 10 doctors would discourage anyone from entering the profession. It’s hard for anyone outside the profession to understand just how rotten the job has become—and what bad news that is for America’s health care system.

Unfortunately, things are only getting worse for most doctors, especially those who still accept health insurance. To make ends meet, physicians have had to increase the number of patients they see. The end result is that the average face-to-face clinic visit lasts about 12 minutes. Neither patients nor doctors are happy about that. What worries many doctors, however, is that the Affordable Care Act has codified this broken system into law. While forcing everyone to buy health insurance, ACA might have mandated a uniform or streamlined claims procedure that would have gone a long way to improving access to care.

Yet physicians have to go along, constantly trying to improve their “productivity” and patient satisfaction scores—or risk losing their jobs. And now that Medicare payments will be tied to patient satisfaction—this problem will get worse. Doctors need to have the ability to say no. If not, when patients go to see the doctor, they won’t actually have a physician—they’ll have a hostage.

Almost comically, the response of medical leadership—their solution— is to call for more physician testing. In fact, the American Board of Internal Medicine (ABIM)—in its own act of hostage-taking—has decided that in addition to being tested every ten years, doctors must comply with new, costly, "two year milestones." In an era when nurse practitioners and physician assistants have shown that they can provide excellent primary care, it’s nonsensical to raise the barriers for physicians to participate. It is tone deaf. It is punitive. It is wrong. No wonder doctors are suicidal. No wonder young doctors want nothing to do with primary care. But for America’s health to be safeguarded, the wellbeing of America’s caretakers is going to have to start mattering to someone.

Commentary


Dr. John YarbroughCMDA Psychiatry Section Chair John Yarbrough, MD, MBA:“Working as a physician today is different than it was when my father began his practice in internal medicine nearly 40 years ago. Insurances, laws, decreased time with patients, board certifications and electronic medical records are amongst many potential contributors to making life miserable. The demands placed upon us can be overwhelming.

“Recent experiences on a trip to Am_an, Jord_n were unsettling and left me in need of spiritual and emotional refueling. One event in particular while treating Syri_n refugees was when, outside our building, a young 11-year-old girl emerged onto the street with her upper body lit on fire. She had poured kerosene on herself and lit herself on fire after receiving news that her abusive father was coming to pick her up and she would no longer live with her grandmother. This desperate child saw no other way of escaping her situation and is still in a Jord_nian hospital’s ICU with third-degree burns.

“As Christian physicians, the restoring love and grace offered by Jesus Christ dying on the cross for our sins is our path to salvation and an eternity in fellowship with God. While all of us have a wish list of things we would like to see change in our field, our higher calling is our antidote to misery. We are to focus on storing up treasures in heaven and not focus on earthly things."

Country names censored for security reasons

Resources

Faith and Health Resources
Contentment by Richard A. Swenson, MD

3 comments:

  1. America has lost sight of the Bible's role for all of life. Physicians are no exception, even Christian physicians. We drank the Kool-Aid and allowed third-party payers (private and government) to insert themselves AND their layers of administrative bureaucracy between the physician and their patient. This has disintegrated the covenantal view of the physician-patient relationship and left the patient on quicksand. I pray that God will use me in the coming months to set an example for Christian healthcare for the glory of God as I start a clinic on Biblical principles in all respects.
    Eric Potter MD

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  2. John Fulginiti III MD, FACS, MAMay 9, 2014 at 4:10 PM

    While I appreciate Dr. Yarbrough's comments and the spirit in which they were offered, I am a bit puzzled by his concluding statement: "We are to focus on storing up treasures in heaven and not focus on earthly things." If serving the ill and dying as a physician isn't a heavenly calling and spiritual activity, though ever so earthly and mundane in focus, I don't know what is. Ephesians 2:10, God has made us for good deeds, which according to Paul in Romans 12:1 is our appropriate worship. I am concerned when we split our life into spiritual and non-spiritual dimensions, elevating one over the other. The Incarnation demolishes the validity of that approach to life. The light of that blessed reality shows the connection between creation and redemption, spiritual and material rightly related. In this case, making medicine less miserable for everyone is a worthy spiritual endeavor.
    John Fulginiti III, MD Institute for Human Flourishing

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  3. Although I dont disagree that modern medicine is sometimes unrewarding, I'm surprised that CMDA would republish such a negative article. I'm disappointed in CMDA. This is much more of an inflammatory political statement than it is one of the tragedy of physician suicide. A spotlight article on suicide may well be warranted but this one is cavalier, insensitive and political; not very humanistic. I'm disappointed in CMDA for republishing.

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