It’s easy to become cynical in the medical world: too many physicians feel forced to comply with standard metrics that don’t fit the patient in front of them.
Many physicians are penalized if they refer to a physician outside their network, even if the physician colleague is more qualified or clearly a specialist in the area of a patient’s need.
Physicians have always had economic and time pressures–in making a living. That’s not new. 20 years ago our studies show that physicians and patients had opposite opinions about whether (and how much) doctors should be paid for doing postmarketing clinical research in practice.
But what is new is the intensity of the pressure on primary care, the hidden and subconscious motivations to put self-preservation before patients in practice, and the economic pressure doctors feel to avoid financial penalties.
This is especially so for employed physicians, for whom “employment itself is dependent upon pleasing their for profit masters,” which of course is how most workers work! Most physicians are not unlike other workers: they do more of they are paid well to do, and less of what they are not.
There is intense need here but not all of it is self-centered: it affects patients deeply. For example, my essay about primary care physician burnout, and what’s needed to protect primary care clinicians, garnered 27k views on KevinMD.com within a few days.
There are alternatives to physician burnout and cynicism. Some have been studied and show real benefit: protected time, access to truly healthy food, protected leisure, the experience of flow in work, an actually healthful green environment, healing gardens, writing, cooking, exercising, group talk or another approach altogether.
The most powerful alternative for affected patients, employees and families, however, is different. It is to learn how your own body works. Become an expert in it. Get an Owner’s Manual. Learn culinary medicine.
As a short term remedy, find an advocate in the health care system. I’ve served in this role unofficially for friends and family.
Being a guide through the medical system for someone else often saves the patient and family not only misunderstanding, anxiety and fear, but unnecessary or unwanted testing, appointments and procedures…and thousands of dollars. Media, technology, education and research companies are more likely to provide advocates than health care companies.
Finally, look at what is being offered in traditional physicians’ offices as the potential for a therapeutic relationship with a clinician. At heart she truly does care about your health, survival and well-being, but you, as a patient or caregiver, have to take the lead in asking the right questions for your body, your family and your own health care.