I didn’t know them well.
They were primary care doctors on the hospital staff where I served on the Medical Executive Committee. They provided care to the most vulnerable members of our community, both in the hospital and their offices. I feel guilty for not recognizing that each of them was personally suffering, as they took their own lives.
Losing lives of those saving lives is heartbreaking.
Doctors heal people. While most professions rarely involve life or death, physicians hold patients’ lives in their hands. This challenging role requires responsible and learned experience in medical decision-making to “do no harm.”
The public is not aware that the rate of suicide for physicians and medical students is double that of the general population and is increasing. Why?
A contributing factor is the takeover of the medical profession by business interests. So instead of utilizing medical skills and knowledge to benefit the health and well-being of patients, doctors are now forced to monitor bottom lines and profit margins.
Physicians are acutely aware of the costs of delivering quality medical care; in fact, it often feels like a juggling act. However, rather than having the freedom to balance the risks and benefits of treatment, external business interests skew medical decision-making toward profit, undermining the moral and ethical integrity of medical professionals.
Playing a role also is the burden on doctors’ personal finances, greatly affecting many physicians with hundreds of thousands of dollars in medical school debt as they work to establish their practices, raise families, and buy a home.
In my day, over 40 years ago, graduating medical students and trained residents typically pursued a path into private practice. However, as business increasingly influenced medicine, these opportunities diminished, making group practice, including HMO, the trend. Unfortunately, business contracts adopted metric standards, compelling doctors to focus on numbers instead of patient benefits while threatening to terminate these contracts if goals are not met.
Following the Hippocratic Oath has become more challenging.
Too often, I have witnessed ultimatums from hospital administrators, insurance companies, and medical groups that sever contracts or reduce payments, forcing doctors to compromise patient care to maintain business profits. Who is truly being threatened? The patient.
But it has taken a toll on doctors, as they have been asked to compromise not only their training while sacrificing compassion and empathy but also their morals and ethics. Every day, they experience the same guilt I felt for my two colleagues.
What is the solution?
Two options come to mind.
One involves recognizing the stress that doctors are facing, while the other focuses on profiting from medicine. Addressing the latter might help alleviate the challenges of the former.
Let’s face it, from the very start, doctors are high-energy personalities navigating through pre-med, medical school, residency, and then finding their place in the world to practice. For some, various innate survival skills enable them to emotionally sustain many decades of caring for sick patients.
Identifying these innate skills is a challenge, and researchers are conducting studies and surveys to gather information that will help clarify potential solutions for how to deal with the mental anguish they face. Time will tell.
However, decreasing profits from medicine is a more challenging task, as it requires a willingness to implement changes that the business community will resist. Businesses’ marketing of this demonstrates the extensive influence of their public relations department.
Labeling any efforts against these business interests has often been dismissed as “socialism.” However, data clearly shows that health care in the U.S. ranks significantly lower than in many other countries. Certainly, we have the best scientific tools for achieving a healthy nation, but poor statistics serve as a warning that the pursuit of profits undermines the ability to attain good health.
Many organizations and political parties have proposed ideas to improve health care. I am a member of the Physicians for a National Health Care Program (PNHP), which has put forth numerous proposals to enhance health care in our country.
However, business interests and their political and PR tactics are frequently used against those advocating for essential health care changes that everyone should know about. Open discussions free from business PR manipulation are crucial.
We must not forget to provide psychological and emotional support to doctors and all health care professionals who contribute to their communities.
We need to help those who save lives from losing their own, which starts with not sacrificing compassion and empathy for those we serve.
Gene Uzawa Dorio is an internal medicine physician who blogs at SCV Physician Report.
