Sunday, January 9, 2011

Why I Feel Shame

In response to commenters on my last post. Why I feel shame (from KevinMD):

Are physicians motivated by virtue or are they passive victims?: "Often the individual likes their physicians and thinks of him or her as a “knight.” This is the belief that the physician has the patient’s best interests in mind at all times and takes the needed steps to be sure that the patient is always placed first. But society overall does not think this way of physicians. To most, physicians have long ago lost their “Marcus Welby” status and instead are driven by the desire for a high income, reduced work load and less attention to the patient and the patient’s needs. With this sort of attitude, society through its elected officials and through the insurance apparatus erects many polices and procedures to guard against the “knave” doing harm, reaping too much income, etc"

2 comments:

WarmSocks said...

That makes sense.

I guess it depends on one's motives. Patients sometimes talk of only getting 5-10 minutes with their doctor and being rushed out the door without having their concerns addressed. Doctors whose motivation is to rush through zillions of patients in order to rake in as much money as possible ought to feel shame.

It doesn't have to be that way. Doctors doing their best given the system imposed on them have no need to feel shame. My doctor schedules 15-20 minutes per patient, but spends more time if it's needed (or less, if everything is covered more quickly). Perhaps he's earning less than those who zip through twice as many patients, but he can have the satisfaction of knowing that he's doing the right thing and providing exemplary care. Job satisfaction counts for a lot when considering quality of life.

To Be Or Not To Be MD said...

I've heard that sentiment from people at times. I would imagine it can get beyond frustrating as a physician. Our culture is very skeptical, especially in assuming that everyone is out for themselves and money. It's unfortunate that because of "big money" interests involved in our healthcare system, physicians take the brunt of the public's suspicions.

From what I read, it sounds like seeing as many patients as possible is a necessity for physicians just to stay in business (especially in the case of primary care). Overhead costs are increasing, but reimbursement rates stay the same or decline. The reimbursement system we have rewards specialists for doing procedures, but much of primary care services often involve physician time. I would hope that this changes - primary physicians ought to be paid for their services, even if that service is their time more often than procedures.