Why Your Doctor Comes Across As An Asshole

This article from The Lancet is a must-read for anyone who has a doctor.

And if that doesn’t apply to you, well, see previous thoughts on that topic, then get a doctor, and THEN read this article.

Every third sentence, I seriously had to keep myself from standing up and shouting, EXACTLY! (In my empty apartment.) You should hear my internal monologue when I’m talking to my patients.

I’d like to add: I’m getting a little sick of people talking about how doctors never have enough time for them because they’re evil money-grubbers who are more worried about the bottom line than the human being sitting in front of them; they push through as many patients as possible so they can fill their Olympic-sized backyard swimming pools with as much money as possible. Yes, some doctors are like that. But no matter how much you hear about them, my experience is that they’re the exception, rather than the rule, especially these days.

There are enormous pressures on a physician’s practice these days, and a lot of them are financial. The clinic where I did my Family Medicine rotation had to do Botox injections on the side, just to balance the books financially so they could keep taking Medicare patients without going bankrupt. And their schedule was PACKED. We saw patients every fifteen minutes. Which SUCKED, both for us AND (especially) the patients. But the only other option would be to close the clinic to Medicare patients. It was the only holdout in town; if we stopped taking low-reimbursement patients or went bankrupt, the Medicare patients in the area would have been SOL. (That stands for “surely out of luck,” Mom. 😀 )

I read comments on blogs and newspaper articles about health-related stuff a lot, and so far my favorite comment to illustrate this point was as follows: “I get reimbursed fourteen dollars for a physical. How much do you pay for a haircut?”

There’s not much awareness about where exactly medical dollars go. Yes, we’re pouring money into the medical system right now. Niagra-Falls-style. But I’ll tell you one thing: it sure ain’t going to the doctors on the front lines. It used to be that going into medicine was a sure first-class ticket on the gravy train. But that’s not always the case anymore, yet the perception survives the current reality. (Your typical medical resident starts out at least a quarter of a million dollars in debt, due to the absurd cost of a medical education. And no one ever bats an eye when doctors’ salaries are eroded.)

On a personal level, my patients often accuse me of being greedy and heartless when they’re upset with me for whatever reason. I get it; it’s what you say to your evil doctor when they’re being evil at you. Or you threaten to sue them. Whatever.

But it’s kind of hard not to take the prevailing cultural attitude personally. I did well enough in med school and on my Step exams that I could easily have gone into one of those super-cushy specialties that would pretty much set me for life. But you know what? I’m doing underserved internal medicine, in one of the most messed-up hospital systems in the country. I am not there for my health, or my pocketbook. Certainly not.

It was my first-choice program.

And you know what? I still have a see-x-number-of-patients-in-a-day schedule. Because there are a LOT of sick people. It sure doesn’t do my bank account any good.

But hey. Evil doctors are evil, and they evil the evil with their evil evilness of evil.

I get it. I swear I do. People who are scared and in pain lash out, and it’s often hard to remember not to attack your allies. (It’s understandable; it’s always safer to attack people who are on your side; they’re less likely to hurt you back.) But I can’t help getting irritated and ranty when I read stuff on the interwebzes.

Hoo.

I’ll end by saying, if I had the luxury of spending an hour with every one of my patients, I’d be the greatest doctor IN THE UNIVERSE. Not to mention the happiest. And so would your doctor.

But try finding someone that will pay us a living wage for that. Especially in this day and age.