The difference is in the act of trying. To
earnestly attempt a task previously overlooked/not thought of despite the
finite moments in any given day. This is the difference between healthcare as
it should be, and what it is realistically. It is no surprise that American
healthcare is in shambles. A third of the U.S. GDP (gross domestic product
– the market value of recognized goods and services a nation produces over a
given time frame) is healthcare.
Corporations are purchasing clinics and
hospitals. There are instances where physicians are opting to close the doors
of their practices and either retiring, or, joining ranks among the hospital
staff. Healthcare is becoming a monopolized business, rather than the “Mom and
Pop” solo/joint private practices of years past. Americans are also demanding
more services, and insurance companies are appropriating more dollars toward
sick care rather than preventative care – aspects that are questionable. Now,
I’m not denying the presence of the business aspect of practicing medicine.
After all, labor costs of employing support staff and supply costs are the two
largest expenditures of any business, whether it is a restaurant or small
clinic. Then, there are building/maintenance costs, utilities, etc. etc.
However, that only makes up a portion of healthcare. It’s important to make a
living while ensuring one’s business remains viable; yet, so is remembering
those who are the reason for business: patients.
Our healthcare is in dire straits. Yet, not much
headway is being made to quell the screams of healthcare professionals and
patients. Nurses and physicians are over worked. The intended purpose of
support staff such as medical assistants, physician assistants, nurse
assistants, etc., is failing. It has become impossible to meet a demand that is
increasing exponentially, daily. Medical schools aren’t increasing their
enrollment numbers, just as the number of medical schools in the U.S. haven’t
been keeping pace. Matriculated medical students are choosing to
specialize/sub-specialize rather than go into primary care, as reimbursement
for services rendered is better than the former and greater income means paying
off nearly two to three hundred grand in student loans, sooner. It takes years
of primary schooling, an average of four years of university studies, and four
years of medical school (unless one is a part of the PH.D/MD program, then,
this number is increased by one year) just to earn one’s medical degree…
this is not taking into account the additional 3-6 years of residency (depending
on specialty) – or, any additional training years for those in fellowship (sub-specializing)
– before one is a fully board certified physician. Therefore, I ask: where is
the incentive to become a doctor? After all is said and done, how has the
healthcare field not imploded upon itself, in totality? How are we not
roasting marshmallows over the burning rubble of the U.S. healthcare system?
I am an advocate for patients and doctors, not
professionally, but on a personal level. I am studying to be a physician while
undergoing rigorous testing to shed light on what is causing my health to fail.
Therefore, I am not a stranger to either side of the argument. Physicians
aren’t allowed to be healers, and few patients have a strong doctor-patient
relationship with their treating physician(s). It also seems that the media has
pitted doctors and patients against each other, and it is unfortunate because
the true culprits are neither party. Yes, there are horrible doctors, just as
there are patients – several of them – who are the devil incarnate. The
question is what makes these individuals horrible: a piss poor outlook on life
in general? Depression/mental health problems that are under/untreated?
Substance abuse? Debilitating illness/pain? Sleep deprivation? Physical abuse?
Socioeconomic standing?
As a populous, we forget to remember our
shared humanity. First and foremost, doctors are human beings: what makes them
bleed makes you bleed as well. Under the lab coats/scrubs/professional garb, is
a living and breathing person who functions the same. However, they are tasked
with ensuring that the quality of life/health of their patients doesn’t go to
shit; whereas, the patient’s primary responsibility is to recite an accurate
history and be compliant with treatment (in a perfect world, at least).
Physicians deal with quite a bit of stress, on a daily basis (insurance,
time constraints, etc. etc.). On top of that, imagine having to learn that
sometimes “helping others” means helping another die with dignity, or, help
someone maximize their quality of life with whatever chronic condition he/she
has, which is counter-intuitive to why many choose to become doctors in the
first place. Imagine the frustration, when more times than one cares to
acknowledge, having to deal with a patient who doesn’t truly want help/refuses
to help themselves. Now, add Big Pharma hounding you to prescribe their drugs,
insurance/government aid red tape, etc., screaming patients, phone calls, and
all that jazz into the equation. Running a practice/being a physician is the
most stressful – and most rewarding – process. So please, if your doctor(s)
enter into the examining room with a genuine smile and still looks “put
together”, thank them (and your lucky stars, because you’ve got a good one).
As for patients: yes, navigating healthcare is
the cause of several spikes in blood pressure/foul moods. Medical terminology
is a language unto its own, and it can be aggravating when the physician
forgets to switch gears, and speak human. As a pre-med student, trust me,
learning the language is just as annoying (although awesome at the same
time, because it’s like having a secret code). There are several different
terms to describe one frackin’ process. So, yes, I more than
understand your frustration/confusion. However, physicians have spent the
greater part of their adult life/working life using medical terms on a regular
basis among their peers. Also, it is their job to demonstrate the correct
terminology not only among colleagues, but with their patients. However, with
patients, the challenge is effectively translating the subject matter into
something that is coherent/easy to understand (not as simple as it seems,
and takes tons of practice).
As a “professional patient”, the single most
irritating/de-humanizing aspect about the medical field is being cared for by a
physician that needed to either: a) not have become a doctor (or even
thought of being one) in the first place; b) fails/refuses to leave their
profession for whatever reason, when it is clear they hate their job; and my
personal favorite, c) are so reliant on statistics, that they fail to think
critically - so when a patient doesn't fit within a specific statistical
picture, theses type of doctors resort to medical cop-outs/stereotypes (despite
historical data demonstrating the opposite is true)... These individuals do
a major disservice to their profession and the patients they treat. Not only do
they add insult to injury, but they are dangerous. I hate, hate,
doctors who have become so jaded that they either forget their shared humanity
with their patients, or, don’t give a shit altogether. With the first instance,
I am able move past it, as we all get this way from time to time (the key is
to recognize those instances and take appropriate measures to quell the
resulting attitude). However, the latter is something I don’t put up with,
and have called out physicians who behaved this way… then, I made sure not to
be a patient of theirs’ from that point, onward. Why waist time and resources
on a dead horse? It's dead; move on....
Dealing with humanity is a pain in the ass, no
matter one’s job. Yet, a line needs to be drawn. It is a necessity for health
care professionals and patients to be united, in order to change our health
care system for the better. We must figure out a happy medium, and take back
the reigns. More importantly, we need to model the behaviors we wish to see.
Physicians: this means if you wish for an
open and honest doctor-patient relationship, where your patients are actively
engaged in their care, then you must demonstrate your willingness to uphold
such a relationship; you must share your passion with your patients. It’s not
enough to go through the motions of knocking on the examining room door,
standard greeting/questions, and checking off boxes – you know this, and so do
your patients. Therefore, do something about it.
Patients: if you want your doctor to feel
the urgency/concern you do, and wish for a seamless doctor-patient
relationship, then you must – from the very beginning – be
completely honest. Don’t assume that just because you are a paying customer (insurance/government
aid programs contract with doctors at a deep discount, so really, you are
benefiting from discounted services – not the doctor) doesn’t mean you are
entitled to the royal treatment. It is your responsibility to
establish the benefit of the doubt, not the other way around. Lying/being an
asshole (whether an effect of a history of horrible experiences or not),
is counterproductive. Also, when a physician prescribes you a treatment/asks
you to try something, do it 100%.
Yes, I recognize that this is easier said than
done. However, what is worth having requires work. Sometimes, it takes proving
a negative (or several) to get the desired result. All we have to do is
try.
