Medice is a Crappy Gig

Doctors know that doctors are increasingly dissatisfied with their profession. The reasons are many, but mostly stem from an ever-increasing amount of non-clinical work that is not reimbursed (dealing with insurance companies, for instance, for payments or pre-authorizations). Combine that with Medicare payments that have not kept up with inflation (and in fact have decreased) and you have a recipe for disaster for both doctor and patient. The end result is that doctors spend less time seeing each individual patient - the 15 minute visit is becoming standard in primary care - because doctors must cram in more patients during the day to keep the clinic afloat. And then there's all the extra work they don't get paid for, which makes for long work days, sleepless nights, and a fast-track to burnout. Furthermore, a litigation-obsessed culture and the rise of the "professional patient"* that make the years of intense, hard-fought training seem trivial.

What do do?

Most of this is a result of doctors' own apathy to take action, to stand up to crappy work conditions. This passivity is also our virtue, since the majority of doctors are willing to put up with exploitation for the sake of patient care. The equivalent to a physician strike has been threatened by many doctors - refusing to take more Medicare patients if the reimbursement system is not repaired - but ultimately doctors feel that this would violate their professional ethics. Plus it would make the profession look bad in the eyes of the public; rarely does our community hold lawyers, politicians, business executives, or even professors, to the same strict standard.

* The patient who demands certain medical care or self-righteously questions physician expertise after a little bit of internet reading that gives an inflated sense of medical understanding.