Over the past several years, the war on doctors evolved. Healthcare spending in the US represents the biggest expenditure in our economy, and everyone wants a piece of the money pot. Doctors leave the profession in larger numbers as the projected shortage intensifies. The power to practice medicine is being wrestled out of doctors’ hands by third parties in many sectors. But, the war on doctors to gain control of the industry is not devastating doctors alone. The war on doctors is a war on patients as well. And unless this battle is ended, physicians and patients both will suffer.
Who is at war with doctor?
– Third party insurance companies cause the biggest devastation in the practice of medicine. They do not put patients first but rather are driven by lust for their own profits. The average annual salary of an insurance company CEO is over 10 million dollars. Yet, patients struggle to get the insurance companies to cover even the costs of many of their generic medications. There are certain diagnostic tests that will not even be considered without special permission from an insurance company employee. So, despite doctors ordering tests they know will benefit their patients health or even save their lives, it will only be performed with the blessing of an insurance company clerk. Doctors are losing this battle. I see this in my practice every day and it just keeps getting worse and worse. How do you comfort a patient who is crying because their insurance company refuses to cover their MRI and they believe suffer from brain cancer? And as their doctor, you examined them and saw signs that made you suspicious that they may be right. The doctors bear the full brunt of liability in the case of missed diagnoses, even when we try to do right by the patient. Insurance companies and their employees are exempt from any liability for their decisions. They claim they do not practice medicine. I disagree, When they usurp my medical decisions that I made after carefully examining my patients and taking their histories, and calculate that all through the filter of my education and training, they have made a decision and it affects the health of my patients.
– The government is another big warrior in this was on doctors. Many of the frustrations patients feel in the exam rooms are the direct result of new laws and mandates flowing out of the halls of the Congress and Senate. Do you know how patients hate that doctors spend the patient visit looking at their computer screens? Well, doctors hate it even more. The HITECH act signed into law in 2009 set in motion the wide-spread use of EHRs. While tech is good and the need for legible and transferable records clear, this act also set into play many other mandates. The meaningful use program quickly followed, which was heralded to be a means to test that doctors use their EHR in a meaningful. Unfortunately, that meaningful way was determined by the government, not the users of the EHR systems. So, of course these mandates ended up being onerous and useless. While a patient is upset that the doctor is not looking at them, the doctor is more annoyed that they must input numerous and unnecessary information into the medical record. And if we don’t? This year it went into effect that any doctor not participating in the meaningful use program will be penalized a percentage of their medicare reimbursements. And these penalties will increase every year. We own no opinion in this. We protested and explained how this is interfering in our practice of medicine. The governmental ears remain stone deaf.
– There is also a media war on doctors. When you think of all the times you hear doctors mentioned in the news, what comes to mind? There are stories of wrongful surgeries, medication errors, greedy doctors and those who lost their license to practice medicine. How often do you hear tales of the good doctors do? Doctors are saving lives as we speak. They are missing their kids ballet recitals and family reunions to do this. While most people sleep through the night, doctors have their mobiles on the ready on their dressers and night stands to answer that middle of the night call at any time. There is nothing called 9-5 in medicine. I go home when I am finished taking care of my patients. And I may get phone calls for the rest of the night when I go home. Most doctors still treat Medicaid patients for which we get paid very little. In fact, we are lucky to break even on these patients financially. Yet, we do it out of a sense of calling because we believe being a doctor is a noble profession and it is a calling more than a job. Do you know that doctors lose sleep and cry over our patients? And it is a very frequent occurrence but we do it behind the scenes because it is necessary to appear strong in front of our patients. They need our strength even when we don’t have any left. But, the media stereotype doesn’t allow patients to see this side of us.
How is the war on doctors a war on patients?
– When a patient, can’t get a test or medication they need because the insurance company refuses to cover it, they can be harmed. A patient and her doctors fought the insurance company to cover a brain MRI because she was having suspicious neurological symptoms. She was told that it was not a medical decision just a determination of benefits and that she could pay out-of-pocket. This woman is a single mother putting 2 kids through college and working 12 hours a day. She did not have the money and she simply could not do any more to get the amount that was needed. After almost 12 months of appeals she finally got the MRI approved. And sadly her brain tumor was finally diagnosed. This is only one patient but every doctor has scores of these stories. Real harm can happen and will happen unless doctors are again allowed to make the medical decisions they need for their patients. Insurance companies and their employees need to start bearing some responsibility and liability for the decisions they are making, without examining patients or even talking to them. Doctors cannot keep practicing like this and patients’ deserve better, especially when many of them are now paying their own insurance premiums.
– The mandates doctors are forced to comply with are taking time away from patients. In the 21st century, patients are living loner and with more complex diseases. They need are time more than ever in the past. When we cannot give them the time they need because we are busy playing data entry clerk for Uncle Sam, their care will be sub-optimal. It is time to get the politicians out of the exam room and let the doctors and patients be a tea,m again. The governmental intrusion into the health of its citizens will have far-reaching and adverse consequences. We need to oust this fight before more casualties result.
– When people heed media stereotypes of doctors, there becomes a fissure in the doctor-patient trust. We need to trust each other in order to achieve the best clinical outcomes. Doctors need to trust that patients give us accurate information. Patients need to trust that we hold their best interests to heart. The media casts doctors in a negative light and people see us as driven for profit. A patient asked me for a medication that I believed would harm her because of her medical problems. She became upset and accused me that I didn’t want to help her because I get paid less under Obamacare. Truthfully, I personally (I am not sure if this is true across the board for primary care doctors) actually get paid the same from most plans and slightly more under Medicare and Medicaid. But, the assumption was there. Sure there are outliers. But, most doctors love our patients. We need more balance stories about good things that doctors do and not just the bad apples.
The war on doctors is happening on many fronts. Doctors are getting burned out trying to give our patients the best medical care while fighting all these wars. Those doing the battle against us possess all the power in this war. They own the healthcare dollar and where it will go. They hold power over us in the ability to perform our chosen careers. We are losing this war because we cannot fight back individually. Doctors need to join together and speak out about the evils in the system. And patients need to join us before these powers lead to very real harms. It may seem like a gargantuan task. But, remember David beat Goliath in the end. And it is time that good return to medicine.
Copyright secured by Digiprove © 2015 Linda Girgis, MD, FAAFP
Patients need to wake up from their sleep or take off their rose colored glasses.The very patients that complain about Dr’s are the ones who are ignorant of what’s happening with the government taking the ability of the Dr to make decisions over their care.It will be too late if patients don’t raise up for support of our Dr’s decision.Patients are dying because the insurance and government interference. Support our Dr’s!!!!!! Vigorously!!!!!!
The medical matrix does not reward good doctors. It’s obcene that it doesn’t.
I have been to many doctors. I have never felt “loved” or anything close to that. I can best describe is as contempt or indifference.
Sure. I was fooled into thinking they did care. Total fool.
I wish I had never met any of them. I will never forgive myself for trusting them. If I could take that trust back, I’d still be a person. A real, actual person.
But it can never be now. I’m supposed never mention it. So, I’ll leave it there.