A response to “You signed up to be a doctor, not a martyr.”

Dear next patient,

I appreciate your letter and your advice. I would sincerely like to follow all your advice concerning exercise, eating right, and spending more time with family. I try to make every effort to do so. Unfortunately, I am in the middle of transitioning for the third time to a new EMR system and managing quality metrics and algorithms.

Also, our clinic just received a negative online Yelp review. Apparently the reviewer had to wait 30 minutes to be seen and wants everyone to avoid our clinic, so I need to deal with that. We just found out insurers have cut our reimbursements for the third time and though we have spent thousands of dollars to ensure compliance we are also being penalized for not complying with Center for Medicaid & Medicare Services (CMS) initiatives. Though we are on our third EMR, we seem to have issues complying with “meaningful use.” Our transition to a cloud-based system was a bit of a struggle, and it has been down for awhile. Thank goodness we have written medical records to back up our EMR.

At great expense, we hired an administrator to help us comply with the new ICD-10 coding system to help us ensure proper reimbursements. Thank goodness for another administrator in our system. I try to keep up with the new changes in the health care system. However, since I need to work during the day to see patients the only time I have available to attend meetings, complete paperwork, listen to webinars, or read the policies and laws on these subjects is in the evenings and weekends. Thank goodness for the videos of my child.

I am glad you would like for my cheeks to see the sun on occasion, to be there emotionally and physically for my family, and not beat myself up when I make mistakes. However, you also expect me, the doctor, to be perfect. That is a conundrum. I would like to maximize who I am as a person. I really try to. I make every effort to eat well, walk as much as I can even if it is up and down the stairs of the hospital, and talk to my family when they need me. And honestly, it isn’t the pure demands of being a good doctor that gets in the way. It is the multiple requirements of the system, the rejection of insurance, the futile attempts to comply with EMRs, meaningful use and Physician Quality Reporting System and Angie’s List that demand my attention away from you, my patient. I am a physician in the most affluent country on the globe. A country which ranks #1 in health expenditure per capita and last place in health status among the world’s wealthiest countries.

When I reached out to my resources for advice on how to improve my lot, a Medscape report in January 2014 suggested I “provide care to prisoners, supervise PAs, serve as an expert witness ( I assume they mean against my colleagues), review health insurance claims (yes, I want more administrative paperwork), examine patients for insurers, work for a pharmaceutical company, staff medical tents at sporting events, work on a cruise ship (take my family while I work!),” and more suggestions along those such lines. Even more suggestions by Medscape in August 2014 recommended I open a medispa or an urgent care center, or dispense medications from my clinic to improve my lot. These are suggestions from my colleagues on one of the most read, physician-oriented websites.

Here is the real conundrum: You do not want to hear me complain about health care system issues, compliance requirements, or especially what we get paid. You just want me to get it done. And that is what I do. I get it done. So forgive my wrinkled scrubs when you walk into my ER with chest pain, the dark circles under my eyes when I am setting your son’s broken bone, and my growling stomach when I am reviewing your lab results going over each and every one of them with you.

Despite the high statistics of new and old physicians wanting out or wishing they had not become physicians in the first place, I love being a physician. With a real passion. Enough to do it knowing I have the highest suicide rate, divorce rate, and have likely cut a few years off my lifespan. I am no martyr. I am dedicated.

I need your help. If you have noticed, I have not said one thing about my years of schooling, my medical competency requirements, medical liability, the need to cater to attorneys, or my constant desire to better myself in my knowledge as a physician. I do not need your help with that. What I need is for you to change your habits to help prevent disease. I need your help to change the health care system. Do what it takes. I have a lot riding on you. You just signed up to be my patient.

Sincerely,

Your doctor

Ben Gonzalez is medical director, Atlantis Medical Wellness Center, Silver Spring, MD.

Image credit: Shutterstock.com