Tuesday, January 5, 2016

Doctors, He Felt, Were No Longer Helping People

It was never his intention that the name would stick.  A decade ago, when he first began working in the restaurant, some of his fellow employees knew that he was formerly a practicing physician and started to call him "Doc".  Although many of his coworkers had since moved on, taking the knowledge of his previous profession with them, his moniker persisted.

Doc liked the simplicity and tedium of his bartending job.  He spent the majority of his nights doing what he liked most, interacting with fellow human beings.  He remembered a time when medicine offered such enticing rewards.  When he could sit across from a patient with a paper and pen and record only the most salient information.  He could look into their eyes, wax philosophical in the exam room, and still have enough time to comfort a grieving family member.

The practice of medicine was once both amazingly complex and laughably simple.  The convoluted path of the ailing body was matched by the enduringly straightforward need to be loved and cared for.  And Doc loved his patients.  He loved them so much, in fact, that the wave of computerization, legislation, and compliance almost got the best of him.

He no longer enjoyed his day to day activities.  His warm greetings and kind words were overtaken by a nagging electronic medical record system and voluminous rounds of paperwork.  Doc was deeply depressed and on the verge of suicide when he made the life altering decision.

He had no children, no wife, and no debt.  He would leave the job he once loved in order to save his own life.

And save his life, it did.

As the months past, Doc felt the stress wash over his body and fall like a puddle to the ground.  He started to laugh again.  He smiled at strangers as they shimmied up to the bar.  He became a spectacle on his own.  A group of regulars appeared at all times of the night to chat as he worked.

It took a full year before the phantom sensation of a pager buzzing on his belt loop finally disappeared.  Double that to get used to sleeping the whole night without being interrupted by a phone call.  Doc was happy, but couldn't forget quite everything about being a doctor.

Although his mind was elsewhere, his keen eye kept lurking back to his training.  He might notice a Bell's Palsy or the shuffling gate of Parkinson's in some unlucky patron making his way to a seat in the restaurant.  Occasionally he gave advice for minor ailments.  Originally his customer's eyes would raise in disbelief, but eventually they learned to trust his instincts.

Once a young man started to choke on a piece of steak.  When Doc heard what was going on, he leaped over the bar and ran to the table.  He performed the Heimlich, and cleared the man's airway.  It appeared as if his actions were too late.  But Doc expertly delivered a few breaths and started CPR.  The man recovered by the time the ambulance arrived.

It was times like these that Doc wondered if he made the right decision.  He still loved medicine deeply.  But he also knew that what doctors were practicing today was no longer medicine.  It was a bastardized version overtaken by technology, administrators, and rules that made little sense.

Doctors, he felt, were no longer helping people.


Anonymous said...

I don't know any young doctors who will work someplace without an EHR nor any mid-level doctors who don't know how to find a job that they love. There are options for direct pay practices and medical home models as well as large systems like Group Health Co-op where the 1000 doctors own the health care system.

He sounds like a Luddite - When they invented knitting machines in the 1800's people bemoaned the loss of the craft of knitting and opposed any new technology or ways of working.. Our current health care system is the worst in the industrialized world, with tremendous disparity and costs 50% more than any other does.. It also over-pays doctors (an interventional radilogists averages $560,000 a year) and under pays home health workers ($7/hour) so it is probably a good thing this guy is behind the bar and not in our health care system.

(doubt you will post this comment because it is based on facts vs emotion)

Mike Gamble said...

So sad, but so true. Today's medical care has become a bastardized version overtaken by technology, administrators, and rules that make little sense in relation to the human body.

Unfortunately, the naive bean-counters in Washington believe that finding the average or statical mean for one particular medical condition will allow them to find the most cost-effective treatment for that condition. While that may be true in some alternate universe, that isn't the case in our universe. In reality, if you have two or more medical conditions, those conditions can interact with each other.

Each of us is a unique combination of factors. For example, if one describes me solely by my 12 chronic medical conditions (and don't take my weight, height, grey hair, age, etc., into consideration), there are 479,001,599 possible ways that those 12 conditions can interact with each other. That's more than the total population of the United States (~320,000,000 in 2015).

In other words, there's no one else exactly like me in the U.S. and there's no single effective medical treatment that can be prescribed by a bean-counter because there are nearly 500 million possibilities of what might work. Instead, helping me with my conditions requires the intuitive capabilities of a real physician. Technology is NOT the solution ... at least not in today's real world.

Unknown said...

I agree totally, a one size fits all medical system will more than likely not fit the vast majority of conditions. The real generator of the highest costs in our health care system has little to do with healthcare. Waste, fraud, abuse, tort avoidance, administrative and government involvement cannot be tamed under the current system. The advertising is also a big issue, with commercials every five seconds describing costly drugs that have counterindications from Florida to California. Graft in the form of bribing from pharmeceuticals to the AMA, all trying to get an ever increasing part of the pie, which is a big pie and getting bigger. This year it will reach well over 3 trillion, and at the current rate of accent will more than likely more than double over the next 7 years. The PPACA has had the opposite effect, making health care access even more costly for most people. Mine has gone up over 400% just since 2011. Even worse, the hospitals lobby to keep certain types of health care within their jurisdiction, because they fear competition from free standing outpatient centers. So competition is being stifled. The boards of medicine are not willing or capable of reigning in the bad apples, and the government's, both state and federal respond with tighter and tighter payment controls. In the meantime, the justice department lets certain providers steal as much as $500 thousand before going after them for criminal charges. Instead, they settle civilly and the theft is perpetuated. Technology is not the end all. At the VA they use blood pressure machines, that are not all that accurate. Is there a solution in the works? Well the guy charged with the solution has been playing the lottery for the past 50 years, and he is still trying to hit. We have as much chance at solving the problems as he does hitting the exact numbers.

Danie Botha said...

I feel with Doc. I believe most MDs (perhaps not only in North America) can feel his pain.
It is a travesty what is happening to Medicine and Healthcare.
Not only in the US. North of your border similar things are taking place, however different.
This intended and unintended onslaught is performed by (some) physicians, administrators, corporations, policy makers alike. Physicians have been sadly reduced to insignificant worker bees--totally dispensable. They are reigned with intimidation and fear.
However, I don't agree that we are no longer helping people--we are, but it is increasingly made difficult and less effective and unsustainably expensive since Medicine has become a strict business for many.
So, what to do?
Speak up.
Find strength and support of like-minded.
Form a voice for change.
Find other outlets to survive.
There is still joy to be found.
And perhaps, find out where Doc works. They may have an opening.
Thank you for the post, Jordan!

nahid hotckiss said...

May be doctors are over payed. I am not sure though how a resident newly graduated will be able to pay the $400,000.00 loan due as soon as he graduates. Oh, he also has to pay for house, car, food, insurance, Etc.....
This is fact and a reality for my son.

Anonymous said...

Exactly why I left full time medicine.

As for the "docs are overpaid" comment...go ahead...go be a radiologist. They are still accepting students.