Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Is medicine a profession or a commodity?

Gene Uzawa Dorio, MD
Physician
May 9, 2013
Share
Tweet
Share

Over the past twenty years, Wall Street business has covertly taken over the medical profession while doctors have been distracted by a deluge of procedural, financial, and legal paperwork. A strategic plan was launched to extract exorbitant profit benefiting business, and is now mainstream without challenge from our profession nor the public.

Legal boardrooms were abuzz in the 1990s as a blueprint assault was made against organized medicine, redirecting a profession into a commodity. Symposiums templated this game plan for hospital administrators, while lobbyists strengthened their legal foothold. Despite recognition of this onslaught in medical journals, the anemic response from physician leadership allowed it to sweep from east to west coast. Now occurring in California, I wish to shed light on this evolution using my experience at our small community non-profit hospital.

Ten years ago, we went into bankruptcy. Located in an affluent northern suburb of Los Angeles County, we were mismanaged, but business professionals were brought in keeping the hospital from closing. At this point, the template commenced.

Not being involved in hospital politics for 22 years, my election to the medical executive committee (MEC) three years ago probably rose from whistleblowing writings in a local blog. Within months, I was falsely accused of code of conduct charges and corrective action was taken against me. Renewal of my admitting privileges were withheld forcing me to hire lawyers preventing the board of directors from removing me from the medical staff. Many of my colleagues faced similar problems, some of whom are no longer on staff. To my surprise, when I told my east coast friends of this problem, they said it had already happened in their hospitals.

California law allowing medical staff self-governance was interfered with and trampled upon by the administration. I found staff meetings with administrators verbally abusive, prompting physicians to videotape these interactions. Not surprisingly, lack of communication at our hospital among the administration, board of directors, and MEC was sanctioned by a national oversight agency.

Medical reputations in the community were sullied by mudslinging, and we were marginalized by the undertones of spurious propaganda. There are some business people adept at this, while physicians are not. Anger by local doctors was temporized though as many have contracts with the hospital and must keep a low profile, especially since this administration was notorious for financially twisting arms and dangling the carrot to silence their voices.

The use of similar tactics to influence votes skewed the board of directors and created dubious conflicts of interest. One member had lucrative hospital building contracts, two had hospital money in their bank, and another did secondary real estate transactions on the hospital’s behalf. Four CEO-appointed physicians had profitable medical contracts with the hospital. One can see how easy a vote might be swayed. The administration used this influence to not only ramrod changes in hospital policies and procedures, but to persecute and prosecute any physician in their way. These tactics continue today.

The only voting member elected from the medical staff to the 15-member board was the chief of staff, and up until a year ago the deputy chief of staff could vote, but this was changed by the board at the behest of the administration.

Has this aggressive template business takeover made any improvement in quality patient care? Not at all, as this hospital still does poorly on national surveys. Then why pursue this onslaught? Profit. We have seen the salaries of all administrators continually increase, with augmented bonuses and concomitant contribution to their retirement plans.

Humanity has been replaced by the fiscal bottom line. Physician decision-making relative to patient care is threatened, and doctor advocates have been subjected to administrative crosshairs. At our hospital, physicians practice in a hostile working environment.

Ignorance is no excuse for not seeing this tsunami takeover of a worthy profession. If being a commodity must be the sacrifice of having excellent patient care, doctors would acquiesce. But with profit being the business motive, igniting the fire of public opinion against this clandestine assault of our profession must begin.

Gene Uzawa Dorio is an internal medicine physician.

Prev

We need a new way to value the work of nurses

May 8, 2013 Kevin 9
…
Next

Why the Connecticut gun law does not improve care for the mentally ill

May 9, 2013 Kevin 11
…

ADVERTISEMENT

Tagged as: Hospital-Based Medicine

Post navigation

< Previous Post
We need a new way to value the work of nurses
Next Post >
Why the Connecticut gun law does not improve care for the mentally ill

ADVERTISEMENT

More by Gene Uzawa Dorio, MD

  • Aging in place: Why home care must replace nursing homes

    Gene Uzawa Dorio, MD
  • How doctors took back control from hospital executives

    Gene Uzawa Dorio, MD
  • Pope Francis dies at 88. What his care reveals about America’s failing hospitals.

    Gene Uzawa Dorio, MD

More in Physician

  • How I learned to love my unique name as a doctor

    Zoran Naumovski, MD
  • What Beauty and the Beast taught me about risk

    Jayson Greenberg, MD
  • Creating safe, authentic group experiences

    Diane W. Shannon, MD, MPH
  • How tragedy shaped a medical career

    Ronald L. Lindsay, MD
  • A doctor’s guide to preparing for your death

    Joseph Pepe, MD
  • How policy and stigma block addiction treatment

    Mariana Ndrio, MD
  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • The myth of biohacking your way past death

      Larry Kaskel, MD | Conditions
    • Why doctors struggle with family caregiving and how to find grace [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • The myth of biohacking your way past death

      Larry Kaskel, MD | Conditions
    • How trust and communication power successful dyad leadership in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Hollywood’s allergy jokes are dangerous

      Lianne Mandelbaum, PT | Conditions
    • How I learned to love my unique name as a doctor

      Zoran Naumovski, MD | Physician
    • My first week on night float as a medical student

      Amish Jain | Education
    • What Beauty and the Beast taught me about risk

      Jayson Greenberg, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 28 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • The myth of biohacking your way past death

      Larry Kaskel, MD | Conditions
    • Why doctors struggle with family caregiving and how to find grace [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • The myth of biohacking your way past death

      Larry Kaskel, MD | Conditions
    • How trust and communication power successful dyad leadership in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Hollywood’s allergy jokes are dangerous

      Lianne Mandelbaum, PT | Conditions
    • How I learned to love my unique name as a doctor

      Zoran Naumovski, MD | Physician
    • My first week on night float as a medical student

      Amish Jain | Education
    • What Beauty and the Beast taught me about risk

      Jayson Greenberg, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Is medicine a profession or a commodity?
28 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...