The Revolution Will Be Tweeted

The doctor/patient relationship is like a conversation. Physicians have been quiet for so long that patients feel like they are talking to themselves. But there is great import in what the doctor didn't say.

It's time you heard the view from the other side of the stethoscope.

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I am not the government. I am not a politician. I did not choose your insurance for you.

When I accept an invitation to lunch or covet a plastic writing utensil, I am not suckling on the teet of big pharma. Chances are, I'm either hungry or need something to write with.

If you left my office with a referral for an xray, cat scan, or mri it was not given to pad my wallet. You will not see me standing in the parking lot of the imaging center high fiveing a radiologist. It is more likely that I had a clinical question that I couldn't answer with history and exam alone.

I am not sadistic. I withhold antibiotics because it is the right thing to do. Not because I want your Thanksgiving, or flight, or 20Th high school reunion to be miserable. My life would be much easier if I was less of a stickler.

When my treatment plan is unorthodox and doesn't follow protocol, it's because I saw something that doesn't fit. I am trying to balance the art and science. I do not make such decisions lightly.

And when you enter the office and I seem hurried or distracted, it's not because I don't care. Sometimes I am preoccupied with worry and fear over another one of my patients.

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You will not hear these words on the TV. You will not see groups of physicians clad in lab coats march on Washington or leave the hospital on strike.

We vote on our feet. Doctors retire early or move to non clinical careers. Primary care becomes extinct and goes the way of the dinosaur. Hours are reduced and lifestyle is chosen over commitment.

But, If you're attuned to social media you'll catch the whispers. The discontent oozes from our keyboards and smart phones.

Because we want things to change. We want to remain physicians. Secretly we hope our words will waft into your ears and be the flint that sparks revolution.

Fundamental change is coming. The question is whether it will be for better or worse.

This revolution will not be televised.

It will be blogged.

It will be tweeted.