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Physicians’ Problems With The Healthcare System

Stanley Feld M.D.,FACP,MACE

I must start this article with a disclaimer. I am a retired Clinical Endocrinologist that practiced Clinical Endocrinology for 30 years. I became involved in medical politics because I wanted to help make Clinical Endocrinology a household word. We succeeded at the American Association of Clinical Endocrinologists to make Endocrinology a household word.

 At that time I saw that the medical profession was slowly being destroyed. I wanted to make whatever contribution I could to save the medical profession in order to preserve the care patients were given and help promote the progress in medical research.

Today I see the delivery of medical care diminishing and the infrastructure of medical care being destroyed by the Obama administration’s ideology coupled by government bureaucrats as well entrepreneurs that see profit in business opportunities that do not add value to medical care.

I do not have a horse in this arena anymore. The only vested interest I have in the healthcare system is that an effective medical care will exist when I need it.

How do we create systems of care that promote high performance? I do not believe it is by a series of top-down highly specific mandates. I believe it is by creating general guidelines for physicians and providing tools to help physicians advance medical therapy using advanced technology.

It boils down to policy makers’ view of physicians.

Are physicians knights to be empowered in their service of patients?

Are physicians knaves not to be trusted?  

Are physicians pawns in a healthcare system to be manipulated by the powers that be?

At present, healthcare policy makers view physicians as knaves and pawns. This view has to change in order to have a functional healthcare system because people behave has you project them to behave.

If the policy makers approached physicians more as knights, physicians would once more behave as knights and not as bitter misanthropes. The result would result in a desire to provide the best possible care for their patients.

The environment is conducive to the destruction of the healthcare system. Barriers that inhibit effective medical care and increase the cost of medical care can easily be overcome if the Obama administration wanted to fix them.

The public and future administrations have to understand the barriers to effective medical care in order for the healthcare system to arrive at a future state that is not on the way to self-destruction.

America’s healthcare system needs a new vision of physicians and patients. The change in vision would result in a new business plan built around a new system of care.

The healthcare systems needs input from physicians and patients. They are the two most important stakeholders in the healthcare system. Without physicians or patients there would not be a need for a healthcare system.

The promotion of a vibrant patient/physician relationship is the keystone to a viable future state of the healthcare system.

I will first list the barriers and then explain them and their solutions in my next blog. Some of the barriers have been covered in previous blogs.  

The barriers to effective and efficient medical care are causing physicians to adjusted in a distorted and destructive way. These barriers are not increasing the quality of medical care they are serving to decrease the quality of medical care.

            Lack Of Malpractice Reform

            Problems Trying to Increase Reimbursement

  • Stripped of Negotiating Clout
  • Turned Into Captives of the Insurance Industry
  • Pressured to Sell Healthcare as a Commodity
  • Pushed to Abandon Clinical Judgment
  • Under Hospitals' Thumb
  • Shunted Aside by Policymakers
  • Shunted Aside by Entrepreneurial Management companies
  • No One Is Advocating for Physicians

The VA Healthcare System is the perfect example of a top down Platonic approach to a healthcare system.  Government bureaucracies have proven over and over again that it does not work.

The American healthcare system needs a bottom up system that is based on empowering physicians to act professionally in the best interest of patients.

The bureaucrats for a top down system should enable a higher level expectation of care from physicians and provide education about the higher level of expectations for patients.

The driver of the healthcare system must be the consumer. The government and physicians must emphasize the consumers’ responsibility in their health, healthcare and medical care.

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

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