Doctors Vent Their Discontent
A recent story in the New York Times talks about some of the reasons physicians are frustrated with medical practice today. I’ve outlined some of the more concerning reasons below. Please, for your own well-being, consider these before you dig yourself too deep into the medical school hole.
1. Loss of Autonomy
“I’d write a prescription,” he told me,” and then insurance companies would put restrictions on almost every medication. I’d get a call: ‘Drug not covered. Write a different prescription or get preauthorization.’ If I ordered an M.R.I., I’d have to explain to a clerk why I wanted to do the test. I felt handcuffed. It was a big, big headache.”
2. Payment Denials
“Thirty percent of my hospital admissions are being denied. There’s a 45-day limit on the appeal. You don’t bill in time, you lose everything.”
3. “Informed” Patients
“Stories of patients armed with medical knowledge gleaned from the Internet demanding antibiotics for viral illnesses or M.R.I. scans for routine symptoms are rife in doctors’ lounges.”
4. Malpractice
“Malpractice worries also remain at the forefront of many physicians’ minds, compounded by increasing liability premiums that have forced many into early retirement.”
5. Decreased Realized Income
“Doctors are working harder and faster to maintain income, even as staff salaries and costs of living continue to increase. Some have resorted to selling herbs and vitamins retail out of their offices to make up for decreasing revenue. Others are limiting their practices just to patients who can pay out of pocket.”
6. Declining Reimbursements
“A 10.6 percent cut in Medicare payments to physicians is scheduled to take effect on July 1. Further cuts are planned in coming years. Many doctors have told lawmakers that if the cuts go through, they will stop seeing Medicare patients. But reimbursement cuts are only a small part of doctors’ woes today.”
7. Naive Pre-Meds
“I was naïve, Saeed Siddiqui said. When I was a resident I thought it was enough to take good care of patients. But the real world is totally different.”
The practice of medicine has made its way over the hill. Don’t say I didn’t warn ya.
All quotes taken from the original article.
The thing is though, what are all us pre-meds who loves the health field supposed to do besides clinical work? I really don’t see any other options for me than to go on to medical school to get an MD and maybe a PhD. I don’t want to live a horribly overbooked life with no joy in the work, but I can’t imagine doing anything other than health. What else can an MD or PhD do that would be so much better?
Imagine how bad it will be if healthcare becomes socialized. If I had a econ degree, I would go into business… and vote for healthcare reform if it’s proposed again.
Dylan R – Your description is the precise litmus test that I use with pre-meds. After taking advantage of any and every opportunity to see what medicine is really like, a person should ask themself, “Is there anything other than medicine I could do that would make me happy?”. If the answer is “no”, then you’re making the right decision to go to med school because you’ll be able to survive the BS and will enjoy the work since you’re fulfilling your dream.
I am enjoying your blog. It is very fitting for what I am going through now. So you didn’t do a residency.. what are you doing now?
@emily
I own and manage a marketing firm.
Dylan R,
You could become a Nurse or PA. You’re still in the healthcare field. except now you are an employee. You may not make as much as a physician (unless you become a nurse anesthetist) but you also have far less headache.
Their is demand for physicians, nurses, and PA’s everywhere. Physicians should be making more money than they are. The advantage of nurses and PA’s is they are employed by reasonable people like doctors and hospitals. Doctors are employed by insurance companies whose first job is to make as much money as possible. The insurance companies don’t have to worry about pissing off one doctor who may leave, because there are plenty of other doctors to contract with. A hospital or doctor employing a nurse of PA wants to make the person happy so they can avoid the costs of employee turnover. The insurance company doesn’t pay the cost of employee turnover: pay a doctor to train? No, residency took care of that, Pay a doctor to learn their billing rules? No, the doctor has to learn or he gets no money. An employer has a vested interest in the nurse of PA after the initial training is done, so they pay good money, and give raises and benefits. Doctors will get paid less and less until they stop taking insurance. Then insurance companies will raise reimbursements slightly and we’ll be back to the same bullshit system.
The real reason is that there are laws preventing doctors from organizing and collectively bargaining with insurance companies for better payments. So we’re all solo docs or small groups who have no power against what can arguably be called an insurance oligopoly. We cannot demand better reimbursements because each group is too small to matter to an insurance company that is contracted with thousands of doctors. The solution as I see it, is for doctors to form much larger practice groups or join large healthcare corporations. In this way you will essentially have formed a legal “union” of doctors in large enough numbers to matter to an insurance company: insurance payments from one company not high enough? end the contract, see what happens next year when that insurance company doesn’t have enough doctors contracted to service their customers who expect healthcare to be accessible.
In your opinion, dearest Hoover, what would be the ideal situation to make medicine “all better”?
I’m working on an English degree– no way can I do medicine, but write to my lawmakers and support AMA initiatives and try my best as a citizen to help fix the problem at the top. I’ve chatted up doctors about what things cost vs. what the government pays and what insurance pays. Last time I saw our family doctor, I felt like I was at a hair salon with the products he tried to push on me, promising to make us healthier. It was add-on sales at their finest. I felt bad for the office and wondered if this would come up.
I was thinking becoming a PA instead of a doctor would be a pay cut but will come with less stress and headace. What are the benefits of beoming a PA over a doctor and what do doctors think of PA’s?
Doctors praised PAs. As a PA, there is less headache, less responsiblity, get to play doctor and still make great money.
As a PA, you will be put down by your senior attending for the rest of your life.
You will be ignored at work and have no chance of promotion.
You will have to suck up your entire life.