Tough Times

C922E4F0-A9F9-4E23-830C-1C409B4C13F3“fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand.”
‭‭Isaiah‬ ‭41:10‬ ‭ESV‬‬

Tough Times
Some days will be difficult and nothing seems good. These tough times are when we need to fully rely on God. I came into work very early on Monday after the Thanksgiving holiday to prepare for an anticipated hectic day. My computer would not work, neither would my printer. There were multiple errors on the patient charts, that I was able to check, and no one would be held accountable for making them, except me by legal default. I am exhausted from travel and stressed about the upcoming holiday madness. Another Monday in the tank! Time to hold steadfast on His promises.

Healthcare Bleeding

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Our healthcare system is truly in a crisis. Most people in the field or using the services clearly see how broken it has become. In effect, the system is “bleeding” money away from patient care and into a vast bureaucracy. A recent study shows that the biggest cost increases have come from insurance companies, pharmaceuticals, and administrations. Physicians, although commonly blamed, do not substantially contribute to the rise in costs directly. Having been in the field since 1981, I am appalled at the attack on physicians from multiple fronts, mainly legal through continued legislation that only adds to costs and derails patient care. We have become hired “guns” and they are looking for cheaper ones; hence, a flooding of poorly trained, mass produced physicians and mid level providers will assume the reigns of seasoned physicians who are leaving the field prematurely, during their peak productive years. I don’t see an easy answer, but am open to suggestions.

Healthcare Reform

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Today I read an article about how the high cost of our healthcare relative to other countries primarily results from the higher cost of pharmaceuticals, insurance companies and administrations. Certainly I feel validated in my long-standing beliefs. But the complexities of our system, considering the expectations and entitlements coupled with liability fears, make solutions seemingly impossible. Earlier this week, one patient who was prominent in the community, expected special treatment because of his social status. Another patient who is totally noncompliant with medical advice expected special treatment because of his sense of entitlement. Adding to the problem, the medical system has prioritized patient satisfaction over quality and allows patients to make poor decisions with little resistance from the physician because of the fear of low patient satisfaction survey scores, which adversely affect reimbursement. Many of us physicians with great ideas are squelched because we represent good patient care over this bureaucracy; and, in case there is any question, WE are not in charge anymore.

Abuse of Physicians

8D29106B-EC59-4CA6-B48F-EDDE2C7DE24BAbuse of Physicians
For years I have been preaching that we physicians do not have basic human rights. Finally there is an article by Dr. Wible, “Not ‘Burnout,’ Not Moral Injury—Human Rights Violations,” which validates some of my beliefs. Our society through the legal system has rapidly increased the burdens on physicians; which, in other people, would be considered basic human rights violations. Our media has switched in my lifetime from reporting mostly positive views of physicians to mostly negative ones. As a result, the real healthcare crisis, in my opinion, centers around the diminution of physician oversight. Most physicians who speak to the public are extremely biased as they are either hired by the government, hospitals, or insurance companies. All of this abuse is possible I believe because our legal system has set the stage with laws that restrict us from our basic human rights.

Layers

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When I think of layers, I generally think of the peeling off of layers of clothing or layers of skin. But today I read an amazing article (Physicians aren’t ‘burning out.’ They’re suffering from moral injury by Drs. Talbot and Dean) on the moral injury of physicians by a broken healthcare system. In my medical mind which has many years of experience, I believe the authors are exactly correct with their assessment. As this kind of honest information about physicians hits the media, I feel the first layers of this massive medical bureaucratic quagmire begin to peel—a glimmer of hope.