Stanley Feld M.D., FACP, MACE Menu


Physicians Have To Wake Up!


 Stanley Feld M.D.,FACP,MACE

It is time for physicians to wake up and take an active part in Repairing the Healthcare System.

Physician job satisfaction is at an all time low. Physicians are uncertain about staying in private practice. Others who have joined hospital systems as salaried physicians are uncertain about the wisdom of that decision.

Patient satisfaction is even lower as medical care is becoming less personalized. The patient/physician relationship has all but disappeared.

None of the secondary stakeholders (hospital systems, insurance companies, pharmaceutical companies and even government) are having a good time. The government is unable to sustain the costs without raising taxes and restricting access to care.

Today, I want to concentrate on the problems as physicians are feeling them.

A reader sent me this commentary a few weeks ago.


"Have you ever been to Sea World?"


"Last evening I was at a staff meeting at my community hospital.  The hospital had recently rolled out “Computerized Physician Order Entry” software that was supposed to enable improvements in the orders and delivering of pharmaceuticals to the patients in the hospital. 

 Apparently, it did not go well.  One of the speakers at the meeting was an articulate physician from the “world headquarters” who came to offer encouragement and reassurance.  He cited the benefits: instant transmittal of the doctors’ orders to the pharmacy. 

Orders were legible, reducing the risk for misreading of the doctor’s handwriting.  Quicker delivery of medication to the patient was also cited. 

After the doctor’s presentation, questions rained down upon his head from the physicians in the audience.

They cited a wide range of problems, and the speaker attempted to answer them with patience and courtesy.

Finally one physician asked, “Why are we doing this at all, when there are so many problems?”  Another added, “Why is the company using an antiquated platform for the new software, since the platform is 20 years old, and so obsolete?”

And so it went lots of problems, and no solutions except a request for patience as the problems are addressed, with remedies apparently months away. 

 That set me to thinking:

 If we go back to the formulation of the >2000 pages that evolved to become “Obamacare”, we would be hard pressed to find evidence of the input from working doctors as the legislation and the resulting regulations were formulated and decreed.

We can, if we want to feel really good, go back to Medicare itself and the rules that came along as to what could and could not be done without pre-approval.

Medicare part D added another layer of similar rules that seemed to appear de novo from sources other than working doctors.

Managed care, in its various ramifications showed a similar tendency to be created by people who didn’t have patients as their first concern, but rather the cost of services. 

So, how, you ask, does all this relate to “Sea World”?

Think about the trained seals act.  The seals do their thing on command from trainers who are not seals.

The seals bark loudly, the crowd applauds, and if the seals perform well, they each get a fish.

Doctors are much like that, in that they do their thing the best way they can, but they are abiding by rules they had little input in their creation, reporting their charges using codes they did not write, accepting payments that have no relation to the charges they report, using a system they did not create and one that gets sillier by the year.

So, fellow physicians, welcome to Sea World, as long as we continue to act like the seals, we’ll be able to get a fish now and then, I suppose."

Ladies and gentlemen, we are highly trained professionals. Our job is to solve and fix medical illness using clinical judgment gained through clinical experience and life long learning.

We are not trained seals.

 It is time for physicians to wake up and take an active part in Repairing the Healthcare System.

 The medical profession got itself into this position because it did not step up and fix the dysfunction itself.

 There would not be a healthcare system with consumers and physicians.

 Neither consumers nor physicians know how powerful they are. Consumers must exercise their power and drive the healthcare system by owning their healthcare dollars and be responsible for their health and their medical care

Physicians must teach consumers how to drive the healthcare system.

The politicians, businessmen and bureaucrats think they can fix it.

They can’t. 

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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