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

Being a doctor is not what it used to be

Raviraj Patel, MD
Conditions
March 31, 2020
Share
Tweet
Share

All my life, I’ve been told that I will have job security. No matter what, as a doctor, I will always have a job despite whatever may come. I have chosen one of the most stable and secure jobs that exist. But did I?

Coming from a family of clinicians — seven physicians, two nurses, and one LPN — one would assume that we are safe and secure, for medicine is the safe house from the economy; however, as the coronavirus pandemic spreads, we see that that assumption is no longer true.

Let us start with the vast majority of the medical world: the outpatient offices and clinics. These settings include cardiologists, gastroenterologists, primary care providers, rheumatologists, dermatologists, surgeons, and many more; and as of a few weeks ago, all of the latter were effectively shut down. Those that have been able to transition to telemedicine have, but our fee-for-service system — which rewards based on procedural volume– has left many of these physicians unable to perform the highest-yield cases. Effectively, gastroenterologists are not able to do colonoscopies, cardiologists stress tests and catheterizations, and surgeons no surgeries other than those deemed “emergent.” This is not a call to pity physicians, but to understand the reality of what medicine has been for some time, but is even more so than ever: a for-profit-industry.

To be frank, physicians are not the ones raking in millions despite the fact that they’re the ones doing the majority of the work and sacrificing years of their life in training. In fact, physician pay has been declining in real dollars since 1990. How can we expect to have good health care when the ones providing it are unwell? We are more burnt out than ever, have more debt than ever — more stress, more pressure, more expectations — than any prior generation in the history of medicine. Perhaps the question to ask is: Who should be rewarded in this system? Because, in my humble opinion, the patient-physician relationship is sacred, and the entire system is designed to facilitate that relationship. If doctors are not the highest earners in health care, then who should be? The hospital administrator? The insurance company CEO? The pharmaceutical companies?

The COVID-19 crisis has only made more evident the growing tentacles of finance, as even front line workers, such as emergency medicine physicians, are being cut from daily staffing – a move that administrators justify due to lower daily volumes. Yet we expect those same clinicians to respond immediately should COVID19 start overwhelming these hospitals. Flex staffing, an accepted business practice with roots in the food and beverage industry, has moved into medicine; however, we are only now starting to acknowledge and accept the detrimental effect it has had on our workforce.  In the flexible staffing model, uncertain work hours lead to uncertain income — and thus, a beleaguered workforce, disenfranchised from the American Dream. Is that what we want from our physicians and, by extension, nurses, techs, and all those in health care?

This is not a call for socialized health care. Italy and Spain both have socialized health care, and yet their response was inadequate. South Korea and Taiwan both have socialized health care and had phenomenal coordinated responses containing the epidemic. If anything, this indicates that it is not a system that defines success or failure, but rather leadership.

Something has to change if the world’s wealthiest, most developed, and supposedly technologically savviest, leader of the free world is unable to protect its citizens by effectively managing crises like this.

America, once a country of abundance — flush with hospitals, doctors offices, multiple domestic manufacturers, well-respected and well-paid physicians and nurses — is under siege by a virus. So, here we are, not enough hospital beds because we closed down so many, not enough equipment or medications because we do not manufacture them anymore, and not enough providers because education costs too much, and being a doctor is not what it used to be.

Raviraj Patel is an emergency physician.

Image credit: Shutterstock.com

Prev

A resident physician’s reflections on COVID-19

March 31, 2020 Kevin 0
…
Next

The small practice primary care response to COVID-19

March 31, 2020 Kevin 0
…

Tagged as: COVID, Infectious Disease

Post navigation

< Previous Post
A resident physician’s reflections on COVID-19
Next Post >
The small practice primary care response to COVID-19

ADVERTISEMENT

Related Posts

  • Coronavirus and my doctor daughter

    Carol Ewig
  • Osler and the doctor-patient relationship

    Leonard Wang
  • How about those doctor hoppers?

    Denise Reich
  • Finding a new doctor is like dating

    R. Lynn Barnett
  • Doctor, how are you, really?

    Deborah Courtney
  • Be a human first and a doctor second

    Sarah Murad

More in Conditions

  • Why medicine must stop worshipping burnout and start valuing humanity

    Sarah White, APRN
  • Why perinatal mental health is the top cause of maternal death in the U.S.

    Sheila Noon
  • A world without vaccines: What history teaches us about public health

    Drew Remignanti, MD, MPH
  • Unraveling the mystery behind one of the most dangerous pregnancy complications: preeclampsia

    Thomas McElrath, MD, PhD and Kara Rood, MD
  • How community paramedicine impacts Indigenous elders

    Noah Weinberg
  • Pain is more than physical: the story your body is trying to tell

    Katie Hatt, DO
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast

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

Leave a Comment

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

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast

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

Leave a Comment

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

Loading Comments...