Any disillusion with medical system?

Dear OldPreMeds… now Docs,

Recently on the NPR’s radio show Air Talk, the host Terry Gross interviewed cardiologist Dr. Sandeep Jauhar. He just published a book called “Doctored: The Disillusionment of an American Physician” where he goes on to talk about the increasingly discontent from doctors about their profession mainly due to the current model of reimbursements in our medical sytem which has lead to severe reduction in the time spent with the patient.

He also goes on to talk about defensive medicine and the great amount of unnecessary testing done in medicine today also due to lack of time, as well as fear of malpractice liability.

For those of you who are attendings and residents, what’s your take? What have you experienced in regards to what Dr Jauhar mentions?

We look forward to hearing your thoughts…

Docs… any thoughts?

It would be great to hear your take; specially as non-trads…

Thank you

I haven’t read Dr Jauhar’s book yet, but I did hear bits of the interview and agree with some of his points. It has become increasingly more difficult over the last three years to check all the boxes the government wants, just to get paid 50 cents on the dollar. For every hour we spend on direct patient care, we’re spending another two making sure our documentation meets meaningful-use standards, answering inquiries from insurance companies to get tests or medications approved, or following up on non-compliance reports. That’s the nature of the beast right now.

That being said, there are still a lot of compelling reasons to get into this profession, and those who are willing to put it all on the line to get here will be the ones to see beyond the daily obstacles, to find joy and fulfillment in their work.

There is conflict in every profession, and sometimes that’s just the way business gets done. My job is to provide the best possible care to my patients, which on occasion includes fighting it out with an insurance company physician or nurse whose job it is to say no to me. Once I accepted that and stopped being angry about it, I found ways to work around it. More often than not it works out in the patients’ best interests. Effective negotiating is part of art of medicine; it just doesn’t always happen in the exam room.

Would I have been this accepting of the current state of medicine if I hadn’t had another career prior to medicine? Probably not. Would I have been happier practicing medicine 20-30 years ago vs now, like most physicians my age? Doubtful, because this is the moment I chose, good or bad. I’m involved on a community and state level to try to change the system, but I’m not going to abandon it if I can’t.

I would never discourage anybody from entering this profession at any stage in life, but I do think anyone who’s considering medicine should take an honest look at how they deal with frustration. Maybe in a few years the boring voice of reason will prevail and a lot of this CYA and overkill on documentation will go away, but who knows. Keeping good patient care as the guiding principle is never going to be a bad idea.

There are pros and cons not just in medicine but in all professions as we all know. It is important to keep our feet on the ground and figure out the way to stay as fully connected as we can to what we do… Not an easy task of course.

I agree that knowing how one deals with frustration is probably crucial in this case.

Great post btw…

I think the issue is the assumption that medicine is practiced the same throughout the entire country. Is anyone really restricted to practicing in a certain system and area? If where you’re at isn’t conducive then ove. There’s give and take. I know former urban physician who are now country bumpkins who, while they miss the big city, love the opportunities they have with their patients and vice versa. Now that the government’s involved there is no recovering the medical system. Government and big business are making billions soon to be trillions…no incentive to change.