Tuesday, January 8, 2013
Gifts Given And Taken Away
She wanted to thank me for saving her husband's life. I averted my eyes towards the floor and blushingly scolded her. But we both knew it was a half hearted attempt. We both knew that I indeed had saved his life after a series of miscalculations by other physicians.
And I couldn't help but think of other offerings proffered by those who entrusted their care to me. The various trinkets and bobbles during holidays, at the end of a long journey, or just to say thank you. Could I not help but feel guilty?
Over the last year, I've cut my hours in half. Yesterday, I directed my office manager to cancel all appointments on Thursdays. I've decided I'm going to stop accepting new medicare patients.
It's not that I don't enjoy practicing medicine. But it seems like I have become a puppet. The puppeteer pushes gently on his wooden cross and my head turns away from the patient and is buried into an unforgiving electronic mistress. I lift my arm and an invisible string stops it mid motion.
It is only when I abandon patient care that I am free from the ties that bind. My skills are appreciated in other nonclinical realms. Why would I stay?
I've worked hard at mastery. I've spent years studying the appropriateness of care. I do not check PSA tests. I rarely give antibiotics for upper respiratory tract infections. My patients die in hospice at home, not in hospitals.
Yet the brutality of health care reform does little to differentiate. Those laws made to menace the inefficient effect both the best and the worst of us. How many bystander causalities will we suffer? Yet these same bodies that scold us have never even produced a sufficient method for conscientious individuals to measure against.
Medicine is quickly losing its joy. As the day of reckoning draws near,
who will be left?
Posted by Jordan Grumet at 6:52 PM