Last weekend I was speaking to a friend of mine who is thinking about retiring from medical practice... prematurely, like I did. Not because he can no longer keep up with the demands of patient care or the new technology. Not because of ill-health, or exhaustion, or forgetfulness. The problem is a health care system that subscribes...alas, surrenders...to the demand for power, speed, and profit at the expense of excellence, compassion, and human connection.
"America's health care system
is neither healthy, caring, nor a system."
~Walter Cronkite~
When I gave up after thirty years in Family Medicine, I told my patients and colleagues I was
retiring…when I meant I was quitting. (Don't get me started.)
I didn’t put it quite that way, of course.
It wasn’t as though I simply got fed up with things, turned in my stethoscope
and tongue blades, and slammed the door on my way out of the office. I wasn’t
impulsive about it at all. I agonized over the decision for years.
"You can quit your job,
but you can't quit your calling."
~Lissa Rankin~
It had nothing whatsoever to do
with my patients. Caring for them was my passion. I wasn't defeated by the perpetually long hours, nor discouraged by the fact that I’d been running behind schedule
all day, every day for thirty years with no chance I’d ever catch up.
No. What finally got to me was the erosion
of my authority as a physician by self-proclaimed intermediaries who had
neither knowledge of nor concern for my patients’ well-being. When I started out
in medicine, the problem was oppressive paperwork; now-a-days it’s an
oppositional defiant electronic medical record system. A baffling coding and
reimbursement system. The ever-present threat of litigation. A pharmaceutical
industry that invests as heavily in marketing as it does in service. A health
insurance industry whose number one priority is corporate profit…not
compassionate care. Aggravations that follow physicians through life like a
swarm of angry bees.
In my friend's situation, mismanagement stoked by poor judgement and lack of foresight had propelled his department to the brink of disaster. They were understaffed. Plagued by scheduling errors. Preoccupied with plans to expand into something bigger, faster, and more profitable while they were mired in confusion and frustration...all problems he could have remedied if he'd had the go-ahead from leadership. Instead, his concerns and suggestions were met with disregard. He felt he had no choice but to resign. To explore a different path forward. Without a map.
"You are never too old to set
another goal or to dream a new dream."
~C. S. Lewis~
Reflecting on his predicament, I put a series of rhetorical questions to him:
- What happened to the drive for excellence in health care?
- What actually constitutes excellent patient care?
- When did our priorities as providers shift in favor of speed, power, and profit?
- Is it possible to restore the sanctity of the doctor-patient relationship?
- Is there any role for compassion, communication, and mutual respect in patient care?
He met my gaze with a blank stare.
Health care providers and patients alike should be worried. I'm afraid we are lost, some of us forever.
"The best way to find yourself is
to lose yourself in the service of others."
~Mahatma Gandhi~
Don't you think it's time we restored rightful autonomy and authority to physicians and health care providers…to men and women who have dedicated their lives to delivering compassionate and capable health care to their patients? To clinicians who are not derailed by the promise of wealth or power? To healers who still believe they have a sacred duty and calling?
"We touch heaven when we lay our hands
on a human body."
~Novalis~
jan
No comments:
Post a Comment