June 16, 2013
In 2008, a series of hospital cutbacks forced our senior administration to a series of closed-door meetings. Physicians, who had the official power of medical decision-making, were asked to use more hospital resources to keep the doors open. Fear of liability was driving up the hospital’s liability coverage of physicians.
In 2008, a series of hospital cutbacks forced our senior administration to a series of closed-door meetings. Physicians, who had the official power of medical decision-making, were asked to use more hospital resources to keep the doors open. Fear of liability was driving up the hospital’s liability coverage of physicians.
In English, that means – order more tests. Increasing
suggestions were made to order those procedures that had high reimbursement
rates. Medical liability and need to
observe the standard of care was emphasized. Uninsured patients were to have
what was medically necessary, of course.
But the message was clear: order more tests with high DRG codes,
decipher the reimbursement rate languages, known as medical coding, and bill more.
Nowhere was patient-centered care ever mentioned in these
meetings.
Perhaps because I believe in the inalienable right of each
of us to make our own choices for our own bodies, I found these meetings to
resemble medical bullying.
Of course, I had experienced it since medical school, but
things seemed to be turning toward the slippery slope of corruption.
I made the decision that staying in the system in my
salaried role would make me victim to the corruption and bind me to the
politics of games of selfishness that fuel the medical-industrial complex and
keep it from being an institution of healing.
The first step was to leave the hospital weeks after my
student loans were paid off. My medical
director had made a practice to take me out quietly for drinks every 2-3 weeks,
and had confided in me about certain decisions.
He had urged me to start a private practice so that I could develop
independence, a sense of entrepeneurship and creativity in my own business, and
ultimately not depend on others for income.
The hospital had already forced all physicians on payroll to
start our own practice, “to help us.” It
was actually so that they could unload us from their books and thereby decrease
the time we spent under the hospital medical malpractice insurance. Of course, we still had to do all the
administrative work in the hospital, but we were paid less. After a few months, I quietly departed, just
before the 2008 financial crash.
Ultimately all these events and observations led me to yearn
for a way to observe the elderly excellent physicians who practice a timeless
science of medical wisdom, where we practice medicine to actually help people
and advocate using our intelligence on their behalf.
It took me five years to get here, and now
I begin to try to practice the real art of medicine.