These are historic times for the US healthcare system. We are watching it destruct before our very eyes. The days of Marcus Welby type medicine are long gone. In fact, only 30% of doctors remain in private practice. This number dwindles every day as more doctors sell their practices, retire, change careers, or simply burn out.
With the passage of the HR2/SGR repeal bill, private practice, especially small practices, will become wiped out. The mandates are too burdensome to bear: EHR, MU, PCMH, PQRS, MOC, ACOs, etc……..we are essentially being pushed into large group practices; and under the thumb of government mandates.
Yes, these are historic times in medicine as the curtain closes on the way we have trained and learned to practice medicine. The doctor is no longer center stage, unless you are watching a puppet show. We are now the supporting cast. Patients no longer have center stage either. The stars are the CEOs, the administrators who are raking in the big bucks and determining company guidelines and what doctors can and cannot do. The co-stars are the politicians, who issue mandates for their own gain, to push their own agendas and to line their own pockets.
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The war on doctors is ablaze. The American healthcare system is being destroyed. Patients struggle to get the care they need, and to pay their premiums and high deductibles. Diagnoses no longer matter. It is cost containment we must try to satisfy these days.
Historically, doctors prescribed the medications we learned were the best for our patient’s condition (s). Our new system teaches us to obey formularies and penalizes us for disobedience. We can try to beat the system and spend hours on prior-authorizations. But, rarely do these time-consuming tasks work and are most often rejected by insurance company employees with no medical education, whom apparently know the best for our patients.
In the days of yore, hospitalized patients stayed hospitalized until they were well enough to go home. Our new age training tells us to treat them and street them or we will have the wrath of administrators rain down on our heads. And then, if they return because we discharged them too soon, we treat them for free because this is a never-event because it was our mistake for discharging them too soon.
Yes, the American healthcare system is destructing before our very eyes. Soon, we will have a system that is unaffordable for many patients even those insured and it won’t matter anyway: there will be too few doctors available to take care of them. The emergency room will become the new PCP but patients won’t need one: they will not be able to afford their medications or the diagnostic tests they need. Healthcare decisions will have to be determined by government or insurance company agents, who work to cut costs, not to ensure patients’ health. Doctors will practice just for their signature to be signed on all the paperwork that needs a licensed doctor to sign.
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Sadly, these historic times in the US medical system will cause great harm to many. Are we willing to just watch it go by? Or will we stand up and demand that patients receive the treatment they deserve?
Photo: Flickr user Andrew Kuznetsov
Dr. Linda Girgis MD, FAAFP is a family physician in South River, New Jersey. She has been in private practice since 2001. She holds board certification from the American Board of Family Medicine and is affiliated with St. Peter's University Hospital and Raritan Bay Hospital. She teaches medical students and residents from Drexel University and other institutions. Dr. Girgis earned her medical degree from St. George's University School of Medicine. She completed her internship and residency at Sacred Heart Hospital, through Temple University where she was recognized as intern of the year. She is a blogger for Physician's Weekly and MedicalPractice Insider as well as a guest columnist for HIT Outcomes. She has had articles published in several other media outlets. She is on the medical advisory board of SERMO. Recently, she has authored the book, “Inside Our Broken Healthcare System” and "The War on Doctors". She has been interviewed in US News and on NBC Nightly News.
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