“Mission statements for health care systems and hospitals are replete with terms like ‘excellence,’ ‘high-quality’ and ‘commitment.’ While these may sound like Madison Avenue buzzwords on a slick brochure, they represent the core values of the people who labor in these institutions. Health care is by no means perfect, but what good exists is because of individuals who strive to do the right thing. It is this very ethic that is being exploited every day to keep the enterprise afloat.”
“The health care system needs to be restructured to reflect the realities of patient care. From 1975 to 2010, the number of health care administrators increased 3,200 percent. There are now roughly 10 administrators for every doctor. If we converted even half of those salary lines to additional nurses and doctors, we might have enough clinical staff members to handle the work. Health care is about taking care of patients, not paperwork.”
The quotes above come from an article in the New York Time. It’s worth reading all the way through. I find it highly insightful and brings to light something I’ve been saying for years.
One morning in Moab, after being up all night delivering a baby, I was on my way to the office for a 9:00 a.m. start at the clinic. In my disheveled state, I passed one of the hospital administrators and told her I had been up all night with a baby and mama. She didn’t respond with, “thank you,” or “is there anything I can do for you?” She simply said, “You signed up for this.” I felt cold and unappreciated.
This kind of attitude, and the administrative burdens accompanying it, are burning out physicians and nurses in record numbers. I’ve spent countless hours clicking bureaucratic boxes, documenting for billers and coders, being on call, and staying up all night—all for free, all because it’s what the system needs, but most of all for my patients.
I actually don’t mind going the extra mile for my patients; it’s interfacing with the complex system they’ve handed me in the name of data collection that diminishes my ability to adequately care for people. I’m squeezed for time and energy, documenting complicated algorithms into computers, knowing that this documentation has no bearing on the improvement of healthcare.
Bureaucrats and administrators implemented these systems so they could crunch numbers, document patient care patterns (justifying lower physician pay if they don’t comply), and, frankly, create a need for their own jobs. I’ve gone round and round with administrators; their imposed burdens leave me less time to spend with and care for my patients. Their reply: “It’s just the way it is. The government mandates these changes, and if we don’t comply, they will dock our reimbursement by xx% per year for the next 4 years.”
So I went sadly back to work. During the six years I spent working in a rural hospital, it made no difference whether I worked in the ER, the hospital, the clinic, labor and delivery, or OR the system was always bogged down and broken. To alleviate some of this burden, we hire people (scribes and staff members) to help us click boxes the way “they” want us to; sacrificing, working, working…
I’ve seen countless examples of patients who needed just 10 more minutes during an office visit to really get to the bottom of their problems. Or 15 more minutes to discuss weight loss and real options for keeping it off. “Sorry, the system does not allow for this.” It’s bogged down with administrators and bureaucrats and their efforts to squeeze us for cash (physicians, nurses, and patients).
I stepped off that broken system after I saw a family suffer major complications from a simple strep throat that should have been diagnosed easily in the office. There was a lack of availability, access points, and affordability. There has to be a way to prevent a 10-year-old American from becoming permanently disabled by a silly (and easily treatable) strep infection.
I created Voyage Direct Primary Care to get rid of these pain points and deliver the exceptional care that families deserve. I no longer click boxes or scramble through loads of administrative silliness. Ditching bureaucrats and their silliness gives me more time to listen to and care for my patients.
I went into medicine for one reason only: to care for patients. That reason will remain my “why” until the day I die. But I couldn’t care for my patients the way I wanted to until I started my own clinic; when somebody else owned it, their why (money) trumped mine (care). This is why physicians need to own and operate their own clinics. This is the type of care Americans deserve.
I believe that if physicians and nurses work together with the American citizens, we can provide a fresh new way of delivering meaningful healthcare; we can revolutionize healthcare and improve wellness nationwide!
I love the direction you are going. Please keep true to your why and help others follow your path.