According to Afshine Ash Emrani, MD, the worst news in healthcare isn’t antibiotic resistance, drug-drug interactions, hospital-acquired infections, and definitely not the alarming rate of obesity in our youth.
No, the worst news is the increasing number of dissatisfied physicians.
The physician, also known in the system as a “provider,” has become a target assaulted by the government. Fee-for-service physicians are squeezed to do less when they need to — order fewer tests, order fewer medications — to save insurance companies money. While at the same time, emergency physicians are forced to run so many tests by law, at jacked up prices, that uninsured patients go bankrupt!
Ironic, right!? You have the insurance companies pulling docs one way — DON’T PRACTICE MEDICINE, SAVE US MONEY. And then you have the government pulling you the other way, saying, PERFORM GRATUITOUS HEALTHCARE WHEN PEOPLE ARE IN DESPERATE SITUATIONS.
AND HOSPITALS CHARGE A TON OF CASH FOR THESE LABS/TESTS/PROCEDURES SINCE PATIENTS DON’T KNOW WHAT ANYTHING COSTS.
AND THEY HAVE TO CHARGE A LOT BECAUSE OH YEAH — INSURANCE COMPANIES MAKE IT IMPOSSIBLE TO GET PAID.
Welcome to the broken American healthcare system.
This insurance-mandated logic has reduced samples of medications to offices and placed more bureaucracy to get authorization for much needed medications and procedures. Simply put, they believe more red tape means less cost.
But this isn’t logical. And it’s brewed a rebellion by doctors.
Over the past decade, doctors have been squeezed by insurance companies with decreasing revenues and Medicare payment cuts while the cost of running an office has steadily increased. Insurance companies constantly send threatening letters to doctors to charge less and spend less time with patients. The advances in medicine have paradoxically caused more concern for fee-for-service doctors: They can do more, but they must contain costs, all the while afraid of being sued for missing a rare but deadly disease.
Doctors are broken. Dr. Afshine writes, “I see them walking around campus avoiding eye contact, hardly smiling. When time permits, few break out in quick psychotherapy sessions to complain about the system, the way cancer survivors do.”
We saw this coming and that’s why we don’t deal with insurance.
Really, though, does our society think that angry, dissatisfied doctors will deliver better care?
With the unleashed assaults on physicians by the government, stringent reporting requirements, and difficult third party reimbursement, the satisfaction with the practice of primary care is dwindling. Fee-for-service doctors spend three to five times as much on filling out forms and documentation than in the room talking to the patient who desperately needs us.
We have a doctor shortage, and the gap between what we’ll have and what we’ll need is widening!
Given the current climate of insurance-based medicine, do you think students are going to want to study primary care, the least compensated discipline?
No, because that’s not how the market works.
Yes, our healthcare system is disintegrating. Doctors are busy taking care of patients AND dealing with insurance companies. Direct care doctors are working on taking care of patients and campaigning to wake patients up to the reality of our broken healthcare system.
We need patients to fight for the providers of care, or else we are headed for the sickest system in the world.