I'm tired that I cannot practice medicine the way medicine is meant to be practiced: with care, quality and timeliness. Economically I feel handicapped as most of the health care dollar goes for administrative costs to health insurance companies, and a large part going to the salaries and bonuses of the executives of these companies, money meant for patient care. It disgusts me that so much money goes to pay medical malpractice premiums and tails, and that our livelihoods are at risks as attorneys consider us lottery tickets, using their clients as entry fees. It bothers me that pharmaceutical companies now look for diseases on which to use their patented chemicals, rather than looking to improve patient care with lower cost, but equally effective medications.
Little of the health care dollar even goes to pharmacies and hospitals, much less to physicians. Now the current administration wants to decrease payments to these three, in order to 'save' the health care system. We already have enough capable people leaving our profession, or declining the arduous journey to become an American trained physician; not to mention the huge number of physician who discourage their own children from following in their footsteps. How sad when we don't want our own progeny to follow us all because we are treated like thieves, or worse, as children who cannot govern ourselves. And don't get me started on the AMA or the specialty colleges, who rarely stand up for the regular, non-ivory tower doctors that roll up their sleeves and care for patients on a daily, fee-for-service basis. The attitude in our country towards physicians does nothing but create a loss of quality of well trained, American-trained physicians.
Doctors get far less of the healthcare dollar than do pharmacies or hospitals, yet without us they would be out of a job. What is the joke: hospitals would be great places to work if it wasn't for all those doctors? There are around 1 million doctors in the country, yet there are over 25 million people in the health care industry. Each physician supports about 25 people... where those in the health care industry do not actually treat or care (for) about patients. Once we actually get reimbursed, we have our medical school loans and ever rising business costs to pay for with our ever decreasing dollars.
Our patients suffer as physicians must see more patients every year just to make the same amount (or often less) money than last year; physician burnout is a well documented and a worrisome trend in our profession. This affects our ability to actually treat patients properly. Then, adding the paperwork and increased regulations put upon us by the state and federal governments, we have even less time to treat patients, read journals, go to seminars or get sleep. Quality of care suffers.
On top of everything else we need to deal with malignant hospital administrators and medical staff members or nursing staff members who can, just for untoward facial grimaces, suspend us and report us to the National Practitioner Data Bank, thus irrevocably ruining our careers, well before any investigation or fair hearing needs to be called. We worked our butts off to get top grades in college, to get into medical school, then residency programs where we often worked 80, 100 or even 120 hours a week, for what? So we could give up nights, weekends, holidays, birthdays, anniversaries and even the birth of our children to practice that vocation to which we were drawn. And how are we treated? We are considered the most vile criminals, cheats and depraved practitioners with no sense of integrity or consciousness, only out to harm those we have struggled so long to serve. If we are so bad, so vile and so depraved, shouldn't we let our patients get treated by witch doctors with voodoo medicine. But of course, that is already being practiced in US hospital.
I really don't need to feel guilty that the profession I have chosen also puts food on my table, clothes my wife and kids, and allows my children to get a college education (not premed of course.) Yet what am I to do when 25% to 50% of my procedures, which are 'authorized' by insurance companies, are not compensated because, although authorized, they are now determined to be uncovered benefits. I have patients come back for follow-up visits, so maybe I will have to sell vitamins and other services to make up for the loss of payments.
Quality of care suffers with less time to see patients and less reimbursement received when we do see patients. We cannot do pro bono work as we have in the past as we have to see an ever increasing number of patients. This extra work is forced upon us when insurance companies, especially Medicare and Medicaid, constantly refuse to pay us in a timely fashion for our time and efforts. And, then once we do see patients our clinical acumen is stifled as we must follow a cookbook approach to patient care.
When healthcare insurance companies siphon money away from patient care and into the hands of the their executives, to support a life style that demands sometimes more than $30 million/year, this decreases money to medical schools for training and research that might create advances in medical care that actually benefit patients. Insurance companies have no incentive to provide better care if it in turn might make patients live longer. Medicine is going corporate, and we, physicians are just flipping burgers so corporations have an improved bottom line.
It is time that we stood up for ourselves. Our founding fathers gave up their lives, liberty and freedom, so that we, their progeny could live in the land of the free and home of the brave. But we are passively giving up our noble lives as physicians, without liberty to practice as we know we should, and without the freedom to stop the government and the insurance companies from turning us in to hourly workers rather than the true professionals we believe we are and forever should be.
I am going to Washington DC. At noon, on Thursday, October 1 2009. I will be on the mall with a few other physicians. We simply decided that we will not work that day and perhaps the day before and maybe even the day afterward. We are not 'organizing' anything other than a vacation from the stress of work, so we enjoy our nation's capital and perhaps even say hello to our congressmen or members of the administration. Perhaps we can show the country that we are worth more than a $5 co-pay; that physicians are more important than a mid-level healthcare worker; and that our profession is needed, our services are required and our practice is a calling to be respected, not a trade that is to be negotiated to the lowest bidder.
I want our services adequately reimbursed so that we may spend more time with our patients, and I want less paperwork. I want less money going into the hands of insurance companies administration costs, less money going into the hands of pharmacy companies for the development of drugs that are either unsafe or targeted for 'diseases' they seem to invent. I want drugs that are as affordable in the US as in Canada or Mexico. I want medical malpractice reform, with caps on all damages, so that we can practice without the fear of needless and unwarranted lawsuits that only benefit the attorneys. I want the National Practitioner Data Bank reformed so entries are made AFTER all administrative remedies have been executed, so due process is given to all physicians and that all entries are reviewed by an independent board of physicians without any ties to the accusing hospital, state or local medical societies prior to submission. And I want compensation for services that pay us enough to allow us to continue formal and informal continuing education, that pay us enough to manage our practices and allow us a living that compensates us for our years of study and training.
And, most of all, I want you to join me in Washington, DC. I want us to get together, so we can share experiences with each other. I am inviting you to join me on the Million Med March. I want you to invite 10 of your physician colleagues and let them know that you are going to be in Washington DC on October 1 2009. I want you to tell them to invite 10 more of their physician colleagues to also join them, and so on.
I have purchased my flight to Washington, DC. I have informed my patients that I will not be available to care for them the week of October 1, 2009, and suggest that they make alternative arrangements for care. Perhaps they can find a good mid-level healthcare practitioner to take care of their traumas, emergencies or deliveries.
Perhaps we can actually have a 'million med march' however spontaneously it may be. See you in DC.