For the past couple of decades, IMHO, American physicians have ironically entrusted the wellness of the American healthcare system, the protection of patients’ rights, and the fair and reasonable livelihoods of both private and academic practice physicians to everyone but those who know our patients’ needs and our own weaknesses best: us. The result has been the devaluation of the physician-patient relationship, the intrusion of the “insurance” middleman into every aspect of healthcare, profit-driven direct-t0-patient pharmaceutical marketing, and our own re-branding as “providers” and patients as “consumers”. We cannot perform and bill for our own Gram stains in the office, for example, regardless of experience and training. I perceive that we are losing more and more confidence in our clinical skills as everyone and their brother questions what we do on sites such as WrongDiagnosis.com; we are more likely than ever to over-order high tech studies. Even when we know that a diagnosis is directly under our noses—as directly detected by our hands—we are more likely to order “confirmatory” tests that don’t add quality, but may soothe our own risk-averse nerves and provide anticipatory defense in the medical record.
I speak from more than the personal experience of being a physician. I speak as a patient, as a mother whose child died in an ICU, as the primary support and decision-maker for an elderly, demented mother on Medicaid, as the primary beneficiary for our family’s health insurance coverage. And I am fed up on all sides.
I just watched the College of Medicine Class of 2011 graduate. I’ve said for some years that medical schools have been failing to produce physicians who understand and can clearly engage non-medical politicians and voters to drive rational and effective healthcare policy. I’ve seen USF Health take up that challenge, and I think it’s working. As they enter their internships, this class is rightfully concerned, yet optimistic, and even more than any class I’ve seen before, motivated to work toward a win-win that centers on the physician-patient collaboration. As I listened to them express their hopes and fears for the long road ahead, I felt a hope and pride for these budding leaders and for those of us who will be their patients that I haven’t felt in a long time. The next few years, maybe decade, will shape our future healthcare system and the care that you and I, our patients and those we love, will receive. Godspeed, Doctors, godspeed.
Tune in to 6 minutes of excellent real-world commentary by Barry Silbaugh, MD, MS, FACPE, CEO of the American College of Physician Executives, “Why are physician leaders so badly needed, and how do we get there?”, at http://quantiamd.com/player/pspkfcp?cid=968&u=bisjsq