Doctors today are often accused of being uncaring. It is what we hear on the television and cable networks and what we perceive in the busy waiting room as we wait to see the doctor to get only for a few minutes of their time. While having lunch in the cafeteria I often hear from other doctor colleagues about how busy their practices have become and how unhappy they are with the way things are going in medicine. They want to spend more time with their patients and help them as much as possible, but feel they aren’t practicing medicine the way they were trained. As a double board certified specialist in proctology I often wondered what direction my career was going. As my volume of patients increased I started feeling the same way.
The System of insurance companies (private or HMO) and government regulations forced us to become robots, dislike medicine and churn out patient volume. The System for which we pay thousands of dollars a month to belong, does not care about your health. Sure the commercials make you feel like they care, but they don’t. Yes insurance companies do help many patients, but I am confident they hinder many more people than they help. When a doctor orders a test the insurance company has to approve it. Why does a doctor train 12 years (4 years undergraduate school, 4 years medical school and 4 years residency) to have an underwriter from an insurance company who has no medical training disapprove of the test? It is because we have been conditioned to believe that doctors only order tests to make money. Sure a small percent of physicians may practice this way, but the majority of doctors deeply care about your health. When the insurance companies deny care, it is the doctor who tells the patient, so the patient hears it from us and not the insurance company so it looks like we don’t care. If the insurance company or Medicare refuses to pay for a procedure it is the doctors who has to tell the patient. Because the insurance companies are not on the front lines of the communication it gives the perception that doctors don’t care. I am sorry to say that for most people, the ‘Affordable Care Act’ will only make it worse (sure it will help some).
Why are doctors so busy? When re-imbursements continue to decrease for taking care of patients, doctors are forced to see more patients to keep their office open. Seeing a large volume of patients increases the workload exponentially as most patients have labs, x-rays, surgery scheduling, follow up calls from other doctors, dictations of reports etc. Each patient requires a lot of follow up from the aforementioned tests. The increased volume places a burden on the workload. More staff is needed to handle this workload which increases the overhead, which in turn forces the doctor to see more patients… and the hamster wheel keeps spinning. If The System cared about your health it would take the large amounts of money you give to it every month and actually spend it on your healthcare. With increasing deductibles the patient already pays a large portion of their bill while at the same time the premiums continue to be exorbitant. Where is all the money going? It sure isn’t toward your healthcare.
When I hit the fork in the road, one way going down the path of seeing more and more patients and the inevitable resentment of medicine vs. the other of seeing fewer patients and becoming the doctor I trained to be, I re-arranged my practice so I could become the doctor I trained to be. I now spend as much time as necessary with each patient, never feeling rushed and treating people as doctors did in days gone by. Listening to the doctors in the lunch room and knowing theirs is the sentiment across the country, I know now that I am the happiest doctor in America.