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The Moral Veil Of Medicine

Starting out in high school when I knew I was going to pursue a medical career I was sold on the higher calling of medicine. I still believe that the art of medicine is a higher calling but not the practice of medicine. This post is calling out my colleagues who have romanticized the job of working in the medical field and are therefore being perpetually let down.

I have thought about writing this post for a while but I’m always careful because I don’t want to give off an aura of bitterness (too late?). I first became aware of this discrepancy in my field when I joined Kaiser Permanente. Before, as a moonlighter, it was very easy to feel the disconnect from patients and rarely did I even find out about any patient complaints.

Once I had signed a contract and committed my life to KP, I started practicing under the same notion that I was an artist at work, I was a healer, and that I had chosen a morally superior path. Yea, I really was that full of myself.

I remember my very first patient complaint at KP. How dare they?! By then I was on track to being a lifer and I was sure enough in my medical skills that any patient retaliation felt like a personal insult.

 

The Art Of Medicine

All of us know about the art of medicine. We know exactly what parts of the medical practice is that genuine, palpable, deep human connection that is delivered with medical precision.

It’s an unmatched feeling to be able to say something to or do something for a patient that immediately eases their fear or suffering. It could be something as simple as giving them hope or reassuring them – but coming from a medical professional, it’s like god giving you a nudge.

I did a virtual medicine shift yesterday and out of probably 45 patients I had 3 such interactions. I knew what the patient had, I felt their fear, I offered them the proper next step and it was magical.

The rest of the visits were also really good, I have no complaints. But it was the more typical professional/client interaction. That part of medicine is more like: I have an expertise or power that the patient wants/needs and it’s about the 2 sides meeting somewhere in-between.

 

The Business Of Medicine

The practice of medicine, the actual business side of medicine is anything but fuzzy bunnies and warm laundry.

It’s about:

  • passing tests
  • getting the proper licenses
  • answering to authorities
  • accepting bullshit medical research literature
  • not being late to work
  • kissing your boss’s ass
  • kissing the scheduler’s ass
  • minimizing patient complaints
  • staying on the good side of the charge nurse

 

When I read this article about online physician reviews and the attached comments by healthcare professionals, I realized that my colleagues for the most part believe that most of what they do is an art. Most of their time is spent answering that higher calling. They are in displaying the stereotypical god-complex that many doctors have.

They believe what they do is more important than the jobs that others perform. For that reason, they deserve immunity or special treatment.

 

 

Are They Patients or Customers?

First, it’s important to understand that we as healthcare professionals don’t get to decide whether patients want to be patients or customers. They decide the role they want to play. And they make their decision based on what they see unfold around them.

If there is anyone in my audience who thinks medicine is not one of the leading money-making industries in this country then please open the WSJ or look at the sector breakdown of your portfolio. You will find healthcare to be usually in the top 3, right under technology and financial services.

Humans look at the money healthcare professionals make, the bureaucracy in the large medical groups, they see the disappearance of smaller practices, and they spend their hours fighting over their medical bills on the phone or by email. I have a feeling that these individuals will view themselves as customers. They have been let down by it and have subsequently disconnected from the possibility of their clinician really wanting to be there for them.

Patients don’t leave online reviews. They will work it out with their doctor or they will switch to another. Customers will blow your ass up on Yelp or any other way they can.

 

So What Are We, Healers or Experts?

I don’t know about my readers but I am in medicine to earn a living. It’s a job, a business, a source of income. It pays my bills. I may not be a business entity but I’m a professional just like a lawyer, a CPA, a mechanic, a plumber or a politician.

I chose medicine as a career track for other reasons, sure. But once I got into medical school and made it through residency it was fairly clear how the game was supposed to be played.

Pinging back to that article above, to make an argument in 2017, in the era of tech, with the internet and social media where it’s at, that there should be no online physician reviews… that’s… pathological.

It’s like saying that terrorism needs to stop – oh but I want to still drive my 2 cars and fly away to a vacation destination a few times a year. And yes we should invade those fucking A-rab countries because they have bomb and stuff.

As for this asshole doctor here, I have no problem with medicine going any direction it likes – it’s dictated by the consumer. I have no intention of steering the medical profession towards the art of medicine and away from the business industry it has become. I accept what it is. I practice within the scope that my license limits me. I accept the complaints and negative online reviews and the occasional lawsuit.

In return, I enjoy the kind of job security that only tenured professors can relate to. I get a disgustingly high salary. I get respect anywhere I go.

As for myself, my doctors, my dentists, my mechanics and even my contractors are always artists to me. I spend time choosing them. I build a rapport with them. I try to show them the respect they deserve for their profession. I don’t want to be treated like a customer by any of them – ever. This kind of relationship takes a while to build but in the end it’s totally worth it.

 

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