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Physician Unhappiness

Physician Unhappiness

There has been much concern regarding physician unhappiness. Recent article by Dr Arlen Myers was excellent called “Take this coat and shove it”. Here is my contribution and concern.

The high levels of physician unhappiness are many, overworked and under-respected. Employed physicians are being driven to comply with Six Sigma lean efficiencies, no more private offices but instead cubicles, no more respect because you are just another “team member” and you must reply to emails, protocols and EMRs You are just another crew member on a ship without a captain.

You used to be the captain, what happened? If you look at the military and corporate America, there is a hierarchy of responsibility and leadership. No not any more in many hospital systems employing physicians.  If you raise your voice over a patient care concern or a demand to higher excellence, a computer icon with the label “incident report” is easily alarmed. In fact, a self destructive new culture has arisen, a “disruptive physician” label could cost you your career! The word “disruptive” in Silicon Valley has been the term of innovation and futuristic change. Not in medicine, politics, oppression of respect and leadership is what this new environment is producing. The physician bears all responsibility in his or hers patient’s outcome, but no ability to press for excellence or improvement when a team member takes a lower road to delivering quality healthcare.

In private practice, I had the ability to deliver the best personalized healthcare. I created my own EMR that was optimized to enhance the team’s workflow and managed the care of my patients. I knew the past medical history of my patients whom I had cared for over 20 years. I had the captain’s role in my practice and my team respected and moved to my guidance.

I believe that there will be a disruptive development in healthcare payment methodology and in insurance contracting narrowing the gap of charges made to insurers and private pay patients. This will give patients an enhanced ability to chose quality and doctors will thrive in private practice again.

Hospitals going in the direction of integrated Healthplan models will succeed as has Kaiser has done.

My pain is from the empathy that I have for my colleagues who have lost the ability to lead this system out of the mud and into the light. The doctor-patient relationship is the light of a patient centric high quality care model. Fight to keep this true.

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Article by Arlen Meyers, MD, MBA

My response to his article.

Hi Arlen,
I really enjoyed reading your article. Very well stated and I agree that physicians have the genetics and training to be great guides in healthcare innovation. The unfortunate reality is that currently doctors are working triple time and can’t do both; clinician and startup CEO. They can find great intellectual stimulation from ideation and invention. This is not enough!

Physicians with great ideas need a pathway to protecting the IP, building a team, forming a company, self funding the early phases. They must have financial skin In the game. They should be advised to team up with an experienced team. Great corporate attorneys are a must as is a part time CFO. Determining proper regulatory guidance with FDA, CE mark and reimbursement pathways.

Then consultants to help refine executive summaries, business plans and investor pitches. Raising funding is a full time job! Presenting to Angel investors, VCs or strategic partners.

Exciting but a difficult ride. A doctor can not both be a clinician and a startup CEO. I know because I tried and failed. I sold my clinical practice 6 years ago and have devoted my full time to healthcare innovation and guiding startup CEOs. I am the managing director of

Aenor Sawyer MD – From Promise to Power of Digital Health.

Dr Sawyer is a leader in Digital Health innovation at UCSF as the Associate Director of Strategic Relations for the Center for Digital Health Innovation (CDHI) and the Associate Director of the Digital Health track in the CTSI Catalyst accelerator. She is a Clinical Adviser to Rock Health, an Adviser to Open Placement and 1eq, and is on the Clinical Advisory Board for Epocrates. Dr. Sawyer co-founded Trinity, a HIPAA compliant, web-based collaboration technology for virtual Tumor Board and multidisciplinary management (MDM) of complex patients, now in pilot at UCSF. Dr. Sawyer has served on UCSF IT committees for Telemedicine, and Web-based/ mobile technology, and is a member of the NIH CTSA TSIG Telehealth Committee. As an ‘Expedition Medic’ for world-record ocean rowers, she has employed remote sensing/communication to provide remote medical coverage and co-developed WEARHUB with Archinoetics. She is faculty advisor to the UCSF Pediatric Device Consortium, Project Director for Roboimplant.

She is co-developing a safe early-mobility device for in-patients (Mobi-us). As an Assistant Clinical Professor in the UCSF Dept of Orthopaedic Surgery, Dr Sawyer combines her interest in innovation with her clinical expertise in Orthopaedics, Physical Therapy, and Exercise Physiology to provide comprehensive musculoskeletal care. She is Director of the UCSF Skeletal Health Service and Director of the Pediatric Bone Health Consortium, helping Pediatric to Geriatric patients optimize their bone health across their lifespans. Dr Sawyer’s career includes 10 years as a Physical Therapist, after which she received an M.S. in Human Physiology and her M.D. from the University of California, Davis. In the Sutter system she Co-Directed a Cardiac Rehab program for 5 years. Upon completion of her Orthopaedic Surgery residency at Stanford University, she completed fellowship training in Paediatric Orthopaedic Surgery and Paediatric/Adolescent Sports Medicine, both at Boston Children’s Hospital, in the Harvard Orthopaedic program.

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