What Did We Demand During Covid Times?

As physicians, what demands did we make during this pandemic? What did we ask for in return for losing a lot of income, having to close down our clinics, having to see high-risk patients without a lot of support? There is nothing wrong with having physician demands and nobody would know about them unless we actually spoke up.

Sure, we’ll always be ready to see patients and sacrifice our well-being to make sure that patients have access and get the care they need. We’ve let laws change all over us, we’ve suffered through courtroom cases, and we’ve dealt with medical board investigations – all for the sake of medicine.

But, CV19 highlighted a lot of problems in healthcare. This time they couldn’t blame the doctor for the pandemic. This time it was the greedy hospitals and the self-serving politicians who weren’t adequately prepared.

Physician Demands

I can’t think of a time when physicians as a group have come together to make demands. Sure, there are groups like the AMA and CMA who supposedly represent me. I never gave them my vote, but yet they represent me.

What about as individuals? I know the few times that I have made demands I’ve been shut down. Just recently I told my medical director at the FQHC that I don’t think it was safe to do telemedicine from the clinic and that she should let us do it from home.

She replied that the only option I had was to be at the clinic. No telemedicine from home. To which I was able to reply with a “no, thank you”. And this was followed up a week later with an email saying that those who were at the clinic were exposed to a CV19+ coworker.

Physicians Standing Up

Do we stand up publicly for ourselves? No. We’re not allowed to make negative comments about the practice of medicine publicly. Don’t believe me? Look at your Medical Practice Act which your state medical board has adopted. The wording is quite clear.

But you know where we stand up? When we’re fighting with the admission coordinator to get our patient admitted. When we fight for a Prior Authorization for a patient.

Or when we have to beg CPS to look into a pediatric abuse case.

Physicians Protesting

I don’t recall a time when physicians as a group stood up to employers and hospital groups and threatened a walk-out.

I know it’s not a pretty thing to do and I certainly am not advocating for that. But as a group of professionals we are a bit passive in such matters.

Physicians protesting? With signs and shit, taking to the streets? No. That won’t happen. Which is probably a good thing. But there are many ways to protest without putting patient care at risk.

Sadly, we see our nursing colleagues do that all of the time, especially those who are in unions. Healthcare isn’t the airplane mechanic industry – you can’t walk out on your patients when you’re committed to patient care.

Burnt out Physicians

Physicians took to social media during the Covid pandemic and expressed their frustration regarding the lack of PPE’s. And we still don’t have proper PPE’s – this is several months after the outbreak first started.

Physicians came out of retirement to step up to the plate and take care of Covid patients. They staffed the wards and ICU’s.

We then posted pictures of ourselves with facemask marks on our face. Likely to show how much we were sacrificing for our patients.

Many, many doctors who were burnt out started feeling a new sense of purpose because of this pandemic. They picked up more shifts and they once again felt like they were doing dog’s work.

What Could We Have Demanded?

• refusing to see more patients per hour
• refusing to be harrassed by the medical boards
• refusing to go through this ridiculous multi-state licensure
• demanding overtime for our extra work
• demanding pay for all our non-clinical busy work
• refusing to allow for telemedicine waivers to expire after this pandemic
• refusing to have to deal with prior authorizations
• refusing to be interrupted by MA’s and emails and inbox messages and pharmacy phone calls during patient care
• demanding a better work environment
• demanding support for mental health issues in healthcare which affects the majority of us
• refusing to be puppeted by non-physician administrators
• demanding accountability for workplace bullying
• demanding transparency in healthcare statistics and outcomes
• demanding a separate judicial process for malpractice cases

This is a limited list and I’m not even in hospital medicine and I’m not a surgeon. I’m sure there is a ton more.

Barrier to Making Demands

• we’re too busy with patient care
• we depend on the income too much to risk losing it
• we don’t feel supported by society
• we don’t feel safe expressing our opinions
• we fear being replaced by APC’s
• we don’t know what to ask for
• we don’t know where to voice our demands
• we don’t know all the career options available to us
• we are too depressed to speak up
• we are too overworked to have enough headspace to think about demands

At any given time, half of all physicians are dealing with some sort of career disaster.

We are dealing with problematic bosses, we are getting investigated by the medical board, we are dealing with a lawsuit, a patient complaint, or mental health issues.

What’s the Solution?

I don’t have a solution for the profession of medicine. But I do have a recipe for each individual doctor, with rather simple and readily available ingredients.

1. pay off all debt
2. spend only on bare essentials until you build a cash cushion
3. build a $100k emergency fund
4. keep experimenting with your career until you find the right fit
5. save and invest money every month to feel secure in retirement

If you’re a young doctor it might make sense to work a lot of hours to pay down your debt and build your cash cushion.

But most of us should not be dealing with the headache of working full-time. Many of us can start our own private practices.

Many of us can get by on some telemedicine work. We can build our own brands and we can partner up with likeminded colleagues to build something bigger.

The concierge doctors and Direct Primary Care clinicians seems to be heading in the right direction.