Now is the time for all good doctors to come to the aid of their profession.  This just in from the front lines:  WAKE UP AMERICA.  You will soon have a health “care” delivery system with the efficiency of the US POSTAL SERVICE and the Compassion of the IRS.  That is if WE continue to allow the undue, agenda driven intrusion of the legal profession on medicine and its practice.

 

President Reagan had the chutzpa to call the former Soviet Union an Evil Empire.  Was he wrong? Too blunt? Factual? Or simply speaking the truth?  How many American political refugees fled the USA to go there?

 

Is there a single physician (note I DIDN’T SAY PROVIDER) with such courage to point to the legal profession and sayENOUGH ALREADY?  It isn’t all their fault really, it is ours. Like the détente of the 70’s and appeasment politics, the enemy didn’t just go away—they were emboldened.  Like the Clinton administration’s lack of response to terrorism against Americans. 

 

Well if we don’t wake up, our profession will resemble the smoldering ruins of the WTC and the Pentagon-- not annihilated by maniacs, but by maniacs with law degrees and a public who wants the right to sue for whatever, whoever, whenever, whether there is merit or not, with an entitlement mentality, in a culture where justice is not blind, but rather, deaf, dumb, and available to those with the most cash.

 

And speaking of cash, what idiocy is the current “copay” system and discounted fee for service?  We have been duped, devalued, disrespected, perhaps dutifully given our own behavior.  I don’t remember the so-called good ‘ole days, but in my short fifteen year career I have seen a few changes.  For instance, there was a time when you would ask a patient “how are you today?” and we would expect to hear something along the lines of “better, worse, or the same”.  Nowadaze the response is often, if not by the patient themselves, by a family member (taking notes as if we are lying), “what’s my cat scan”?  Then you start to answer what some radiologist thinks he/she sees, what it might be, what he is trying to say, and basically engaging in “UNSPIN”, the whole time not knowing if what treatment they are receiving is even working!  It is enfuriating to get legalese instead of medically relevant reports.  Perhaps the original attorneys of medicine are the radiologists. 

 

But maybe not, maybe Ob/Gyn, quite understandably, given the medico-legal gun to their heads, took the “cover your ass” mentality to heart and it has spread, insidiously to each of us because perception is reality.  Good medicine is difficult enough but the standard of care is quickly becoming perfection.  Often the doctor’s opinion is subservient to the mangled care financial constraints.  We bought into the idea that cost effective is to be worshipped above excellence, truth, communication, compassion, and PRIMUM NON NOCERE.  The modern American credo, might as well be rewritten as PRIMIM NON MALPRACTICUM.  Seriously, if each of us is one lawsuit away from being out of business altogether because the liability insurance gets more expensive as income goes down, WHY THEN AREN’T WE FIGHTING to preserve what’s left of a once proud profession?  I don’t know about the rest of you, but I may not have other “marketable skills”.

 

But the onslaught of beaurocrcy and regulation doesn’t end.  I saw an undercover HIPPA police officer the other day.

 

Just as myocardial cells have a limit to their stretch, so does the cover your ass blanket.  If one group of doctors grabs and pulls the blanket over themselves, it may feeeeeel comfortable, but it is often done without regard to the uncovering of some other member of the health care team and spin begets more spin, to the point that we actually speak like attorneys at the bedside, full of equivocations, double talk, and feeeeeel good.  We rarely speak honestly with each other and our interpersonal relationships are poisoned continually by a helpless self interest which places the patient somewhere immeasurably lower on the priority list.   Perhaps I overstate the case to make a point, but aren’t we on the same side?  The bedside. Not the benchside.

 

I place the blame on us.  It is up to us to make it better for everyone, to have the courage to say, EVIL EMPIRE and stop pretending to be helpless.        TO BE CONTINUED