It’s been a rough and difficult year for us. Separation, desperation, depression, illness, and death are scattered among the months that have passed by.  Hope, for the longest time, seemed non-existent. The COVID virus gave the world a “sucker punch,” leveling us all to the ground. Positivity test rates sky-rocketed, death rates at unacceptable levels. The days have been dark.

Faulty political power plays brought havoc upon our country when we needed a strong and positive guiding light. But I choose not to dwell on that; there are vaccines now that promise us a path to lead us forward beyond COVID.  Let us hope we have all learned some valuable lessons from this time of the pandemic so that we may be better able to face the next one, for inevitably there will be a next one.

A constant in all this turmoil has been the unwavering determination and work ethic of our health care workers: our doctors and nurses. Without their skilled and compassionate care, many more lives would have been lost to COVID. There now seems to be glimmers of hope that an end to the pandemic is within our grasp, providing we don’t act foolishly. Vaccination, social distancing,  mask-wearing, and hand washing are still necessary codes of conduct for the foreseeable future.

However, a dark cloud over health care will remain even after the virus has departed. In recent decades, the practice of medicine has been overrun by corporate entities promising security and profit. But at what costs to the doctors and nurses who stand face to face with their patients daily?  The patient visit has been negatively impacted by electronic health records, which were purportedly to be a boon to the practice of medicine but instead have fallen short of expectations.  The physicians’ attention is divided between punching in data entry and attempting to conduct a dialog with his patient. Click-offs on lists in EHRs replace eye-to-eye contact between patient and doctor, shortchanging the sharing of information between the two in the safe clearing of the exam room. Often the patient can feel depersonalized, feeling like only a source of data for the ubiquitous computer screen.

Governmental and corporate mandates that must be satisfied continue to shrink the available time for the physician to diagnose and treat his patient. The line of patients must continue to be processed to assure a positive profit margin for corporate health care. No time for lunch breaks, no time to gather one’s thoughts, no time.

Nurses and doctors feel the burden of the “shrinking day,” a day filled with more duties, more tasks added to what was already a lengthy list. Seemingly, no real acknowledgment of problems is addressed by health system administrators. Rather than doctors and nurses being treated as valuable, trained, and skilled professionals that they are, they are often viewed as simply cogs in the machinery to process through patients. Although they form the backbone of health care, their input is seemingly ignored. Feeling devalued and powerless, they huddle in corners ruminating about the problems but without any true resolution. What was once a highly gratifying profession, the practice of medicine has morphed into simply a business transaction. The needed personal relationship between doctor and patient has nearly been extinguished. As a result,  physician burnout is at an all-time high, along with the physician suicide rate. More and more physicians are leaving the practice of medicine to find equanimity in their lives.

Where is the patient in all this conundrum? Are we just simply consumers of the service provided? What happened to the sacred bond of trust between doctor and patient?  Has that just become a nice-sounding phrase that has been tarnished as corporate health care stumbles over the dollar bills?

With an ever-shrinking number of practicing physicians, the wait time for an appointment is ever-expanding. But a patient can opt-out of seeing a physician and, instead, see a nurse practitioner or physician assistant. To my surprise, there are over 22 states in the US that allow NPs to have full practice authority without physician oversight, and the list continues to grow.

As a patient with chronic health problems, I prefer not to leave my medical care solely in the hands of individuals who lack the physician’s extensive educational training and knowledge.  Unless positive changes soon occur in health care, I and many other patients may not have a choice. A valuable resource, our medical doctors, are being slowly, but surely, forced out of existence and replaced with mid-level professionals. Has this been the plan all along by corporate health care? In my opinion, it certainly is a plausible question to pose.  Please do not allow this to happen. There are solutions if all sides are willing to listen if all sides are willing to compromise.

As for the present and the foreseeable future, doctors and patients continue to search through the overgrown forest of corporate health care for the clearing we have been promised and so deservedly earned.

Michele Luckenbaugh is a patient advocate. 

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