I’m forever writing letters to the editor and Op-Ed pieces. Every once in a while they get published and I find out a couple months later when a friend tells me they liked what I wrote. I’ve decided now that since I put so much effort into writing these pieces, I ought to at least share what I wrote here, even if it’s only my parents reading and listening to what I post here. Thank goodness for my parents. They make all my efforts worth it.
Last month I responded to Dr. Corwin’s letter to the editor of 4 Feb 2014 regarding Health Care for Profit. I agree with everything he said. Healing is ideally not a for-profit profession. However, the types of incentives and pressures to generate revenue Dr. Corwin refers to are also being applied in non-profit settings.
I am a practicing physician board certified in family and community medicine, as well as occupational and environmental medicine. Over the decades I’ve worked as a clinician in public health department clinics, community clinics, a university medical center, as well as private settings officially registered as “nonprofit” medical institutions. The “productivity” pressures are similar across the board; the expectation is that physicians see at least 4 patients per hour in all settings. Most clinics trust that medical charting will get done on the doctor’s own time even though documentation is a critical part of the job.
Administrators don’t account for patient satisfaction or health outcomes. To administrators the main measure of “productivity” is how many patients are seen per hour. Barring major malpractice, one MD is considered equivalent to another MD. That isn’t true for patients. Practicing clinical medicine requires listening attentively to the patient, eliciting a thorough history, taking the time to carefully examine the patient, making an accurate diagnosis, educating and involving patients in the treatment plan,and documenting all of that in the medical record. All of this takes time. Sadly, those who take the time to practice the best medicine they can are pressured to cut corners and practice fast medicine instead-regardless of whether the institution is deemed for-profit or non-profit. Fast medicine is unsatisfactory for patients and stressful for doctors. The only winners in the current system are the bean counters. Honestly, I think one gets more healing from one’s hairstylist these days.