Tuesday, August 5, 2008

Physican Leadership - Why Doctors Voices Are Not Heard: Is It Because?

Why is it as health reform moves forward, doctors’ voices aren’t heard. If you give the matter any thought at all, you will realize others – politicians, policy wonks, health plans, drug companies, and other big health care organizational vested interests dominate the reform discourse?

Why Is It?

Why is it doctors, who are demoralized, about the direction and tone of the health system, aren’t heard? After all, doctors, with the possible exception of new breeds of nurse practitioners and “nurse-doctors,” remain the ones licensed to “practice medicine.” Society depends on us, indeed, licenses us to “deliver care.”

Is It Because

Is it because, physicians are considered,

• to be a “privileged class,” deserving no more than they already have?;

• to make too money already?;

• to be “autonomous” mavericks stuck in their ways and resistant to change?;

• to be small disorganized small businessmen, and therefore easy prey for large corporations?

Is it because, of physicians’

• tendencies to focus on their own profession, to have tunnel vision, and to ignore the interests of society at large?;

• failures to develop a more efficient, safer business model, such as “medical homes?”;

• ineffectiveness in addressing the notion that doctors are primarily responsible for high health costs?

Is it because physicians,

• have knuckled under to managed care, which has forced doctors to see more patients at lower reimbursements, leading to patient mistrust of doctors; who have less time to spend with them?;

• have permitted HMOs and health plans to hijack the primary function of doctors – caring for patients;

• have not had the sense to recognize Americans entrust health care and almost everything else to the marketing, administrative, and informational power of large organizations?

Is it because,

• Internet information, good and bad, has placed patients doctors on a more level playing field, making doctors seem more like ordinary mortals – incapable of knowing everything?;

• physicians have not taken a more proactive lead in establishing systems to assure quality and safety;

• physicians have not been more innovative by consulting organizations outside of medicine on how to please and deal with busy consumers in the course of their daily lives.

Or is it because,

• Physicians are the most visible symbol of a dysfunctional health system, for it they who deliver the care, and it is they who shoulder the expenses imposed upon them?;

• the public and their to-down leaders have ignored the impossible pressures and unreasonable bureaucratic demands being placed on physicians without supplying them with the incentives and resources required to deal with those demands?


Gary M. Levin said...

Damn good post...All of the above.

Anonymous said...

Couldn't be more right. Thank you.