Stanley Feld M.D.,FACP,MACE
I am pleased that I am able to stimulate comments from physicians in various parts of the country. Please keep the comments coming.
Many of these physicians feel trapped by the bureaucracy and medical care policies that are restricting them from developing a real physician patient relationship. The physician patient relationship is precious to the practice of medicine.
The positive physician patient relationship enables an enhanced therapeutic effect.
As stated by a previous physician writer in my last blog,
The patient has a complaint, the physician listens (or not), performs an examination (or not) makes a decision regarding the probable cause of the complaint, writes a prescription (or two, or three), offers some instructions regarding what the patient should be doing to help himself (or herself), says goodbye and asks that the patient return at some future date for reassessment (or not).”
Physicians have been trapped into this behavior as John Goodman pointed out. The patient physician relationship has been destroyed by the dysfunctional healthcare system. Obamacare is accelerating the dysfunction in the healthcare system.
Many tests are done for defensive medicine purposes. In fact the extrapolated cost of defensive medicine is $700 billion dollars a year.
Physicians might even give the patient a shot of something for good measure to prevent a malpractice suit.
The government, hospitals systems, and healthcare insurance industry control the healthcare system.
These secondary stakeholders have made physicians commodities. Physicians are trapped into going through the motions. Medicine is a calling not a business. Physicians have been forced into making it a business.
Physicians are so frustrated with the system that they are joining hospital systems to rid themselves of the bureaucracy and avoid practice responsibility and malpractice suits.
The hope is that it will lead to a “happier life.” Not true.
The privileged hospital employed physicians become the designated spokesperson by the hospital administrator for the staff physicians. They deny there is any anger or frustration toward the government, the hospital system or the healthcare insurance industry.
The rest of the physicians keep their mouth shut and trudge along angry and frustrated.
There is a mountain of pent up anger and frustration toward hospital systems by these physicians.
I received this note from another physician writer,
“Dr. Feld:
When I read your post last week “It’s All About Patients and Physicians”, I thought you were writing to me directly. I have been thinking about this for years. It is not only that software innovation in Medicine lags behind every other industry, but also the focus has not been in the correct area. As with everything else, the medical profession has given control to others.”
This physician is absolutely correct. In a country whose administration and congress is run by lobbyists who are not interested in patients or physicians but are more interested in protecting and furthering their clients’ vested interests the problems will not be solved. Medicine and Surgery do not have adequate representation or resources to make their case to the public.
Perhaps it is because the AMA is too democratic or too civil. The AMA’s customers are physicians. Physicians have deserted the AMA because of lack of representation.
I think the AMA might still have a chance with some bold leadership. After all without patients or physicians you wouldn’t have need for a “healthcare system.”
He goes on,
“Current software tools allow the development of disruptive systems that can put patients and physicians on the same side of the equation, develop networks to allow much better communications, and integrate the future of mobile devices that will transform healthcare. It should be possible to produce change in current relationships.”
It is not only possible it is probable. I need a Posse of consumers to step out and force the secondary stakeholders to not take advantage of them. This must be a consumer driven effort.
Consumers can be organized through social networking just as Internet companies, venture capitalists and citizen expressed their voice on the Internet and stopped the two Censorship Acts (SOPA and PIPA) that were being railroaded through congress. The traditional media did not cover these two bills until the organized effort was working.
President Obama backed these bills until it was obvious to all that the anti-censorship effort expressed the will of the American people.
Patients (consumers) need leadership and innovative software to demand that they own their healthcare dollars and healthcare care decisions.
I believe many physicians yearn for the ability to spend more time with their patients. Patients must demand it also and pressure the government to relinquish control over our healthcare system.
This writer/ physician’s note to me expresses this desire. It is an important story about the physician patient relationship’s key role in patient care.
“Let me begin with a story. I take care of an elderly man who lives in Brooklyn and suffered a stroke one year ago. At the time the patient was visiting with his son, who is a Rabbi in Chicago. The patient made an excellent recovery following high-quality rehabilitation at a Chicago hospital.
He is a survivor of the Holocaust who lives with his wife and is generally independent. Although his walking is slow, he is able to walk utilizing a cane to a nearby synagogue for services every morning. As I was interviewing him last week, he mentioned that most of his day is spent at home with very little to do.
He does not have television, and is not that interested in reading newspapers.
After hearing this, I excused myself to go to my office and bring back an iPad to show him. I placed it in front of him, and logged on to a website sponsored by Yeshiva University (yutorah.org).
I showed him that he would have access to literally thousands of lectures by leading rabbis that he could listen to on demand. His eyes widened and he looked at me with amazement. He asked me if that device needed a computer, and whether it would work in his home. He inquired about the cost.
His wife immediately told me that she wanted one (iPad) for him, and that their daughter would be calling me for the information about setting things up.”
Ninety percent of physicians would like to have time to relate to patients this way. The dysfunctional system has forced physicians to act differently.
This patient recovered from his depression. He is thriving with the use of his innovative device (iPad).
He goes on further to say,
I cannot finish my career in Medicine without finding a way to integrate experienced people with great ideas and insight with young people who know how to create the tools to bring innovative approaches to actuality.
I will describe the future state next. Innovative software can be built in the future state that provides patients with the tools to express their needs and for patients to accept responsibility for their care.
Consumer driven healthcare with the ideal medical savings account will be the foundation of this transformative healthcare system.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
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