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After 10 years in practice, I recently left clinical medicine. Why, you ask? While there are many reasons, here are just a few:
1. Legalities – This one’s a biggie. Many of us are paralyzed with fear, and this issue should be properly addressed. It’s a looming cloud that hangs above us, limiting what we can say or do. While consequences should always be in place to account for errors, the carte-blanche we have in place for anyone who wants to ‘make a buck’ has unfortunately gotten out of hand.
2. EHR Burdens – The electronic health record is a double edged sword: no eye contact, forces us to ask questions that are often unnecessary, it’s difficult to use, doesn’t always work, and needs internet connection. The list goes on.
3. Insurance Companies – At this point, they seem to be making ALL the rules. I mean all of ‘em. I prescribe a medication, the insurance says no. I order an MRI, insurance says no. They make physicians go through hoops in what feels like a passive aggressive attempt to dissuade us from ordering things in the first place. The physician has to put in EXTRA TIME (often time they don’t have) figuring out why, which alternatives exist, and reviewing a patient’s chart again to figure out which could work. My wild imagination pictures them a bully, arms crossed in front of them, arrogantly daring us to approve; their body language yells out, “Make me!”
4. Big Systems – It feels like the formation of one big fraternity. Healthcare is splitting into factions, with each hospital system flexing their muscle in a bid to win the biggest prize – patient adoration and love. It’s really become a tasteless popularity contest, worsened by the fact that real decision-makers sit nowhere near the playing field, but at the c-suites on top. It feels like it’s become a factory, with the physicians mere cogs in the wheel. What’s worse is that patients think we’re in charge because we’re the face they see. It’s perfect for the factory itself, but it contributes to the dissatisfaction and has been at the root of our burnout. And while I laud valiant efforts to develop ‘wellness programs’ to heal the reality many physicians face, I sadly view these as mere ‘band-aids’ covering up the boo-boos that our healthcare system has created.
5. Patient Reviews – Patient empowerment is important but better used to improve health outcomes than perhaps weaponized by the healthcare industry. What we’re starting to see is medical strong-arming, where patients use reviews as leverage against the ‘other side’. Don’t want to give me an antibiotic? That’s fine, I’ll just write you a bad review! This is especially important to address now, as we head into a future in which physician salaries will be based on what these reviews say.
6. Billing Codes – As if learning medicine wasn’t hard enough, someone decided to throw a new language in there, in order for the physician to appropriately bill. So instead of simply saying that you saw someone for a cough, you need to expand by giving it a number. If this were straightforward and clear, we’d still find this cumbersome, because we already have to learn so much. But the fact is, there are over 70,000 existing codes these days (I know because I looked it up.) Plus, it changes every year! To make matters worse, we often struggle to find the right code because the process isn’t exactly ‘straight-forward’. This adds to the amount of time a physician has to spend on administrative work.
That’s it for now. Those are some of my reasons for making this change. There are, of course, many more. I’ve found a solution to bringing about change, and it starts with our individual – and collective – physician voices. I started SoMeDocs as a way to bring about change. Through groups like this we can connect and brainstorm on how to get things done, make things better. It starts with us.
Dana Corriel, MD
Board Certified Internal Medicine Physician
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