Every weekday I drive down a 13 mile stretch of interstate to get to my office right next to my hospital, or should I say facility. Over the last few years I couldn’t help but notice during my drive to work that of the seven new building construction projects, six are hospital facilities. These include physician offices, smaller satellite hospitals and a couple of other random medical erections structures. This all started as we were coming out of the recession and virtually no other construction was underway. So I started to think, which can be dangerous, “what the heck is going on here? Why, all of a sudden, are the hospitals building so much?.”
“Why, all of a sudden, are the hospitals building so much?”
Here is what I discovered, and you are not going to like it. And I am not the only one talking about it.
The new really big thing in medicine, and I mean really big, is the migration, actually stampede of physicians to become employed or should I say slaughtered. Nobody is really paying much attention to this altruistic movement . . . it’s all good.
Just in case some of you have not picked up on the finer points, I am actually a patient advocate. While I am angry most of the time at what happens to you concerning the mysterious ways of the medical field, now I am down right PISSED OFF, as you will be as soon as you read on. And for the record I am not and never will be employed.
The employed docs are happier because they get paid more for basically the same amount of work; however they won’t ever tell you that. What they will tell you is that they like the reduced stress of less paperwork and administrative headache of private practice and they can just sit back and take care of patients. Let’s just say that explanation would be only half truth. Most of us docs are very sincere about the taking care of patients part; however the bureaucratic, paper pushing, go to meeting commitments are far worse being employed, not to mention rushing patients through everyday on a corporate time schedule. Then just wait till your contract is up for renegotiation. Too f*****g bad, you made your bed. That’s what you get mixing medicine and business. But what the heck, they are making more money as long as they play the game. It’s all good.
Increasingly, physicians find themselves working for individuals that have never trained in the health professions or cared for the sick.
Patients think it is good because they are getting that connected, team approach to their medical care. Hells bells, its just like the Cleveland Clinicor the Mayo Clinic right in your own backyard. It is all good for you until you actually try to use it and you get the bill. Your local, contrived medical systems popping up around you are about as coordinated as my golf swing. You are the consumer, so just ask yourself as you encounter these new systems: are they really better? Are you getting more attention? Are you getting more time? Is the care improved over the dreaded “private practice”, non-employed doctors, you know, the old way?
Now these systems are presenting non-employed physicians as inferior. Their employed physicians are the same docs who were in private practice just a year ago, heck, a month ago. Somehow being employed as a physician must magically increase our IQ and medical knowledge by some measure and by default makes us better doctors.
Then there are the actual bad guys, the non-profit hospital systems (75% of non-government hospital facilities are non-profit) engineering this power play by generously snatching up all these poor docs and providing all this quality care. What a bunch of good samaritans. What a bunch of crap. Three-card monte comes to mind. Why are these bureaucratic, conglomerate hospital systems gaming the system?
Cuz they can!
Here is the question that must be asked. Where is all this new money coming from?
Medical care ceased to be an individual activity in 1983. When President Reagan introduced the use of DRGs to reimburse hospitals for Medicare patients the world changed forever. Hospital managers were given a financial motive to inquire into and manage some of the details of clinical practice. The rest is history which our profession has, to their own peril. ignored. Healthcare is delivered by organisations and the biggest changes are yet to come. The combined effects of increasing costs (which triggered President Reagan’s initiative), technology and burgeoning consumerism will effect changes we can but dimly see. Doctors need to stop resisting and to get on board before they are swept aside in a torrent of new technology and new professional roles.