In the past, the
practice of medicine was a noble profession regarded as a precious connection
between doctor and patient, one-of mutual respect, trust, and care. Through the
years, these perceptions have changed substantially to the detriment of both
patients and doctors.
On SERMO, the top social community for physicians in America, there recently was a lengthy thread about what patients really think about their physician. The consensus was that patients possess a mistaken idea about their physician's financial interests. Clients understand that medicine can be a business, however they don’t understand where the money goes, and this has damaged many physician-patient interactions.
In my youth, there was a family physician that lived down the street, he made house calls. I'm fairly certain his practice was mostly done in cash and his patients knew what they were paying for. There were no practice managers or “physician extenders” to improve revenue. I doubt that he was in it for the money. He loved the practice of medicine and could focus on his patients. He eventually became chief of staff of the area hospital. He wasn’t an expert administrator and the hospital lost money, however it didn’t really matter as it was a charitable hospital and the nuns had a vocation. Things have definitely changed, and many of us are worse of because of it.
On SERMO, the top social community for physicians in America, there recently was a lengthy thread about what patients really think about their physician. The consensus was that patients possess a mistaken idea about their physician's financial interests. Clients understand that medicine can be a business, however they don’t understand where the money goes, and this has damaged many physician-patient interactions.
In my youth, there was a family physician that lived down the street, he made house calls. I'm fairly certain his practice was mostly done in cash and his patients knew what they were paying for. There were no practice managers or “physician extenders” to improve revenue. I doubt that he was in it for the money. He loved the practice of medicine and could focus on his patients. He eventually became chief of staff of the area hospital. He wasn’t an expert administrator and the hospital lost money, however it didn’t really matter as it was a charitable hospital and the nuns had a vocation. Things have definitely changed, and many of us are worse of because of it.
Today I read physician’s blog. He posted a chart that I believe sums up why medicine has changed. It showed a gradual modest increase in the numbers of physicians between 1970 and 2009. On the other hand, the numbers of administrators has skyrocketed and grown over 3000% in that same time period. We fail to provide care when we have to focus on meeting performance targets, work under the risk of lawsuits because we are no longer trusted by our patients, and encumbered by so many rules and regulations that the patient is nearly an afterthought.
Can we actually restore the trust? Has patient care improved? If our first obligation is required to be to managers and organizations that are dedicated profit and “quality measures”, it appears unlikely that we could regain that confidence. Do you think managers have enhanced care's delivery? Are we denying patients the most basic method of care--being present with them and spending time listening? What are your ideas around the commercialization of this once respectable career? Are we losing the way, can we find our way back?
