Do Not Pass Go

I'll give you three nights in the hospital for a a hundred days in skilled nursing. 

How bout a lung mass and a go directly to hospice minus room and board?

Oh... your stay was deemed an observation, do not pass go, do not collect a hundred dollars!

I sometimes don't know whether I'm doctoring or playing some insane nonsensical board game.  The complexities of sickness and healing have been eclipsed by the administrative nightmare of our payment system.  Providers no longer stress over diagnosis and treatment, we huddle with social workers and agonize over disposition.  Families no longer sit at their loved one's bedside and hunker down stubbornly in the face of the ravages of disease, instead they pace lonely hallways hoping to bypass the phone tree and speak to an actual person at the insurance company.

Try as we may to manage our patients pathophysiology and psychology, we now attempt to manage their checkbooks.  Not only the finances of our patients, but the economic well being of a nation is being placed at our doorstep. 

We are not accountants.  We are not economists. 

We neither created nor profited from the distorted system that we loosely call healthcare (to the extent that others have).  Most of the time, we slunk around the edges trying to squeeze the fat to create a few drops of precious water for the parched.

Let the doctors doctor.

For God's Sake, that's what we were trained for.