Saturday, August 30, 2014

WSJ Essay: Why Doctors Are Sick of Their Profession

"All too often these days, I find myself fidgeting by the doorway to my exam room, trying to conclude an office visit with one of my patients. When I look at my career at midlife, I realize that in many ways I have become the kind of doctor I never thought I'd be: impatient, occasionally indifferent, at times dismissive or paternalistic. Many of my colleagues are similarly struggling with the loss of their professional ideals."
"It could be just a midlife crisis, but it occurs to me that my profession is in a sort of midlife crisis of its own. In the past four decades, American doctors have lost the status they used to enjoy. In the mid-20th century, physicians were the pillars of any community. If you were smart and sincere and ambitious, at the top of your class, there was nothing nobler or more rewarding that you could aspire to become...."

"Consider what one doctor had to say on Sermo, the online community of more than 270,000 physicians:

"I wouldn't do it again, and it has nothing to do with the money. I get too little respect from patients, physician colleagues, and administrators, despite good clinical judgment, hard work, and compassion for my patients. Working up patients in the ER these days involves shotguning multiple unnecessary tests (everybody gets a CT!) despite the fact that we know they don't need them, and being aware of the wastefulness of it all really sucks the love out of what you do. I feel like a pawn in a moneymaking game for hospital administrators. There are so many other ways I could have made my living and been more fulfilled. The sad part is we chose medicine because we thought it was worthwhile and noble, but from what I have seen in my short career, it is a charade." (read more)

19 comments:

Michael Haz said...

Everybody gets a midlife crisis. MDs aren't any different. The doc in the article is unhappy, but not so unhappy that he has moved into another field.

Beloved Commenter AReasonableMan said...

I feel like a pawn in a moneymaking game for hospital administrators.

He is both a pawn and a beneficiary since the modern hospital is a streamlined money making machine.

He could have gotten a job with IBM as an engineer and had the same experience.

Michael Haz said...

Mongo only pawn in game of life.

The Dude said...

In other news, Michael Sam was cut by the Rams. Madison hardest hit.

Trooper York said...

He was cut?

From the team or did he decide to have a sex change?

Sydney said...

Since the 1990's there has been a steady shift in medicine from the self-employed doctor to the mega-corp employed model. It is just peaking now, but that is why there is so much unhappiness. These are men and women who were trained to think autonomously but they are now expected to be an automaton.
For myself, I am middle-aged, but still self-employed in solo practice and I still love medicine, and my patients. My colleagues who have given up their practices to the mega-hospitals around here- not so much.

The Dude said...

Man, you have been reading too much Spinelli!

YoungHegelian said...

Medical costs for years now have consumed 1/6 of US GNP. There was no way in hell that so much money was going to flow through the old medical practice system, which was, in essence, medical practices as Mom & Pop shops. That large of an amount of money attracts the attention of mega-business, which is exactly what happened.

It's real hard to turn down money, for everyone, but especially for a group of professionals who worked so hard & started out with so much debt. But after a while, big cash flow means you've got a target on your back.

Paddy O said...

Pastors and professors feel the same way.

Previous assumption of absolute wisdom has been deflated by real experiences of human fallibility.

Doctors, and pastors and professors, are being treated like the rest of humanity.

Honesty hurts.

KCFleming said...

@Haz: Damn right. He needs to buck up. No one -no one- is going to feel sorry for doctors.

Waaaah, my profession has been commodified, like everyone else's.
Hegelian's on the money, too. Success breeds competition. So what?

Worse, Sandeep hasn't been a full time MD for even 10 years yet. A job? Yeah, it's a job. What'd you think it was gonna be?

Sandeep comes from a culture that has a "high power distance", meaning that certain people and professions are treated as superior to all. That shit don't cut it here, and it ain't been that way for a long time. Get your head out of India's ass and look around. This ain't the Punjab.

And Sandeep, dude, you're a New York City Democrat. You voted for this shit. Quit bitching. And fuck you for voting for Obama. Fuck you very much.

The Dude said...

Pogo - you go!

I couldn't have written that better myself.

KCFleming said...

Dollars to delhi Sandeep didn't hold a menial job in high school or college.

I work with a bunch of people like that. They crossed into medicine in that brief moment where university prof could see patients 2 half days a week and teach two one hour classes and get paid pretty well. That's the ideal he is speaking of.

It's gone, Sandeep, dead and buried and the husk is dried out.

And what really bugs him is that should he leave his current doctor post, there are fifty people lined up behind him, ready to jump in.

See what I see, Sandeep, the sign on the door with your name on it is stuck on with Velcro!

Surely they covered this in Buddhism or Hinduism.
Did you not think they meant you?

Michael Haz said...

It's Sazarac o'clock.

KCFleming said...

Sounds like a plan.

Lem the artificially intelligent said...

Dollars to delhi... lol.

Lem the artificially intelligent said...

I thought Pogo was going add notes to the violins...

lol... was I wrong.

KCFleming said...

Thanks for the shout-out Lem.
Yer a prince.

Eric the Fruit Bat said...

My brother-in-law complained that during his residency there where obvious charity cases who condescended to him as if he were their personal servant.

Telling him to get them a soda. Not addressing him as "doctor." Not even so much as a thank you. That kind of stuff.

That was 25 years ago.

He stopped practicing almost immediately afterwards, to his credit.

Eric the Fruit Bat said...

It wasn't all a downer for my brother-in-law, however.

To this very day he delights in telling stories about how he could order that unruly patients be given some drug that caused complete paralysis, except the person was wide awake.

"You could see the terror in their eyes."

He also got a kick out of having the power to order a patient forcibly restrained and hauled away "like a writhing sack of potatoes."