From the
PRESIDENT
JOHN L. ROBERTS, MD
GLMS President | [email protected]
UNHAPPY DOCTORS MAKE FOR UNHAPPY PATIENTS
S
o writes Sandeep Jauhar in his 2014
book "Doctored: The Disillusionment of an American Physician."
And, physicians are unhappy. A survey
of nearly 12,000 physicians conducted in
2008 for The Physicians’ Foundation by
Merritt Hawkins and Associates revealed
only six percent of physicians described
the professional morale of their colleagues
as “positive” and 42 percent of physicians
said the professional morale of their colleagues is either “poor” or “very low.”
“Patient relationships” ranked highest on
the list of things physicians find satisfying
about medicine, but 63 percent said that
non-clinical paperwork had caused them
to spend less time per patient. Sixty percent of doctors would not recommend
medicine as a career to young people. By
all accounts, things have only gotten worse
since 2008.
In the Doctors' Lounge section of the July
issue of Louisville Medicine, Larry Griffin,
a highly respected obstetrician in our community, wrote of the “rapid deterioration
of the practice of medicine in this country.” In his article, Dr. Griffin raged against
corporate medicine’s focus on RVUs, the
electronic health record programs that
rob physicians of precious time with their
patients, and corporate greed. Dr. Griffin’s
article has generated a lot of discussion
both inside and outside doctors’ lounges
in this city. While “the views expressed in
the Doctors' Lounge… are not those of the
Greater Louisville Medical Society or Louisville Medicine” hospital administrators,
leaders of health care systems, and employers of physicians should not interpret
Dr. Griffin’s sentiments as the rantings of a
doctor from another era. These sentiments
are pervasive in our physician community,
in all age groups, and in all health systems.
Why is this issue important? Because unhappy doctors make for unhappy patients!
And unhappy patients can affect the bottom lines of the physician’s practice and
health care system. Moreover, unhappy
doctors are more prone to making medical
errors, to document their care inappropriately, and to show their frustrations to patients. These affect the quality and safety of
health care and lead to malpractice suits.
Finally, unhappy doctors are more likely to
show signs of burnout leading to early retirement, physical and mental illness, alcoholism and substance abuse, and suicide.
Are the leaders of hospitals and health
care systems hearing this message? Many
physicians in our community think not.
More cynical physicians believe the hospital leaders know that physicians are unhappy but just don’t care. These cynics feel
that the hospital administrators are in control and, with non-compete and dismissal-without-cause clauses in the contracts,
can do what they wish with little regard to
physician satisfaction.
What happened to the promise of the
Physician Executive? Remember the call
for physicians to learn leadership skills
and earn an MBA so that physicians could
lead our health care system and thereby
stand up for the patients’ interests and
our profession? Has the promise of physician leadership been largely unfulfilled?
It is commonly stated in doctors’ lounges
that those physician leaders, having now
found themselves in leadership roles,
seem to have drank too much of the corporate Kool-Aid. Many physicians have
expressed the feeling that these physician
leaders have sold out and no longer watch
out for the patients or the doctors. And,
while these physicians understand the
concept of “no margin, no mission”, they
feel the margin has become the mission
for these physician leaders.
In Dr. Griffin’s article he asked, “Do I have
an answer?” and answered, “I fear not.”
I’d like to think the answer lies in improving dialogue between physicians and the
leadership of hospitals and health systems.
We, physicians and administrators alike,
are in a difficult time in the evolution of
our country’s health care. I believe that
we are good people who aspire to provide
high quality, safe and effective health care
to the men, women and children of our
community.
Historically, rich dialogue occurred
among doctors and between doctors and
administrators in doctors’ lounges and
on medical staff committees. But that was
when medical staffs were made up of independent practitioners and when primary care physicians in the community
frequented the hospitals. The character
of the doctors’ lounges and the medical
staff committees have changed over the
years and these longstanding lines of communication are not what they used to be.
Doctors’ lounges and medical staff committees are now populated mostly by employed physicians. Are these physicians,
with non-compete and dismissal-without-cause clauses in their contracts, free
to tell the emperor he has no clothes? Are
the administrators getting the message
they need to get? Who is the voice for the
employed physicians? Who is the voice for
the independent practitioners who no longer go to the hospitals yet continue to refer
their patients to the employed hospitalists?
GLMS can be the voice of these and all
physicians in our community. GLMS
has proven itself effective in addressing
and resolving conflicts between physician practices and insurance companies
through the GLMS Insurance Issues Resolutions Committees. Perhaps it is time for
us to consider a similar model to improve
communication between physicians and
our health care administrators.
Dr. Roberts is a neonatologist with the
University of Louisville Physicians and the
Vice Dean for Graduate Medical Education
and Continuing Medical Education at the U
of L School of Medicine.
AUGUST 2016
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