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.