First let me say I’m not trying to troll. I’m really upset about this and want to know if anyone has encountered this issue and how you might reconcile it. I’ve had issues for a long time with how the current US medical system is set up - you know, the whole “we don’t care if you end up homeless, we’re going to get our money or you can just be sick” mentality that seems to be the way healthcare is practiced here. Full disclosure - I have had some medical bill issues in the past (double billing, overcharging, the typical stuff everyone has at some point). Nothing astronomical, but certainly enough to annoy me. That’s not where my anger comes from though. I’m angry because I see friends and family around me getting these astronomical bills and having to declare bankruptcy. I read articles about people who had to choose whether or not to get care based on how much it would cost. I see doctors not willing to care for patients because they aren’t sure they can pay. This is NOT the way I want to practice medicine, but it’s so ingrained in the medical culture that it makes me second guess my decision to enter medicine at all. Of course I don’t want a doctor who has to moonlight as a waiter to make ends meet. But I also don’t want a doctor who thinks it’s ok to treat some patients and not others based solely on money. What happened to the Hippocratic Oath? Pretty sure it doesn’t include anything about money being a precursor to treatment. Is anyone else struggling with this?
Rachel, There is not a physician, administrator, nurse, or hospital that does not share your anger. No one started in medicine to “turn people away”. My father has been the director of a psychiatric and chemical dependency program for the last 35 years. We have talked countless times about how frustrating it is for him to have someone walk into his program asking for help and he would get them through "detox’ and then have to let them back out to the streets due to insurance. My suggestion is to not focus on the negative, as there are many things that will be frankly out of your control. If you truly want to treat everyone regardless of ability to pay then I suggest looking at Emergency Medicine. ED physicians must treat everyone regardless of ability to pay. Now I will agree that Tx may not be more that stabilizing, detoxing, etc. but it is a field where you treat the gun shot victim with no insurance, the same as you treat the gun shot victim with the worlds best HMO. Focus on what drives you to be a physician and weigh it against what frustrates you. If your passion does not far out weigh the negative than I suggest you do seek another way to help people. The reality is that this path is hard and this job will come with challenges far exceeding the path itself. Best of Luck, Cheers.
You bring up some pretty serious concerns that should be addressed before you go a step further. I don’t think any of these problems are going to be solved before you get through school and residency, so it’s a question of how much are you willing to deal with once you’re on the other side?
I never got into this to make money, but the reality is I have obligations just like everyone else and those have to be met (not to mention the god-awful debt I racked up getting through school). What’s broken is the system, not the doctors. I don’t know any physicians still doing this for money or prestige. We spend our days seeing patients who are sicker and have no money for medication, then we spend our evenings fighting with the insurance companies’ prior authorizations, mountains of paperwork and EHR documentation. We never get to the end of the paper trail; all we can do is try to keep the monster under control. The illusion that we’re out there cherry-picking patients and living it up is just that. I drive a 7 year old Audi and I shop at Costco. My faculty parking deck is full of beaters and I see my colleagues at Costco all the time. But you know what? At the end of the day, it’s all worth it because I get to care for those patients and make a real difference. I have a window into their lives that no one else has. I get to help train the next generation of physicians who will keep going regardless of the debacle our elected leaders make of our health care system. It’s everything I thought it would be and more. So the answer is no, no second thoughts and no regrets.
It’s a deeply flawed system with enormous frustration and enormous personal reward if you are truly called. The best advice I can offer is follow your heart. Regardless of what you do, there will be difficulty and things out of your control. If you love what you do, the reward will far outweigh the frustration.
- jmdmd Said:
Ok, you are my new hero!. I want to one when I grow up (if that ever happens...)
More seriously, Rachel, I totally agree with your frustrations and share them. I come from France, a socialist country with on the best healthcare system (in fact ranked first by many world organizations). So it is troubling to see the US, the first economy in the world with the best technology in healthcare to rank so poorly.
Like many others I do not think that health professionals are to blame. For one thing, there are countries where doctors make more money (Australia, Netherlands to cite only two), and yet, healthcare spending is not what it is here.
I think that the entire insurance industry should be heavily reformed (for non-profit), and to the risk of making enemies that the government should be playing a heavier (and probably different role). This is what all major developed countries have and it all works out much better for them. I am not a socialist, but there are a few things where social is good (other than to write off debt of big banks and make rich folks richer). Healthcare and education are two of these major structures in which social is good.
But I am not here to change the world. We have a crappy system and we have to deal with it. It won't change overnight for sure, but I think (and I hope) than more and more people are realizing that it just doesn't make sense at all when animals are treated better (and for less money) than people.
Like you, I am very frustrated, and I do hope that this will allow me to make my job better, because while the system is very crappy, there are also many opportunities to make it better. How? No idea. I have to get in there first.
I may sound naive here. But I have seen a great system at work (and believe me, it is truly great elsewhere, not perferct, but great). So there is the hope that one day, some things will change here for the best.
- celticdoc2016 Said:
An individual could also practice in a rural area or an urban clinic/hospital.
As long as hospitals and insurance companies are allowed to be "for profit", the problem will continue and NEVER go away.
Basically, GREED is ruining this country!