Doctors And Patients Are Both Losing in Our Health System

As I advanced through medical school and into my family medicine residency, I was increasingly exposed to the “inner workings” of health care. Behind the scenes I saw much of the doctors’ time spent on issues other than patients’ health. Seemingly, the documentation about what they did took more time that what they actually did. My mentors frequently vented behind a mountain of charts about the decline of their profession. (Maybe the TV show just failed to show Dr. Welby filling out 5 pages of paperwork after he treated a simple sprained ankle?)

Hospital and clinic staffs consisted of small armies of people to do coding, billing, following up on denied claims, prior-authorizations and on and on. To financially support this administrative structure, the doctor(s) would take on more patients. The average primary care physician is now responsible for 2500-3500 people! I was frequently told “efficient” doctors could handle double and triple booked schedules – and it would be required to keep a private practice afloat. Unfortunately, this efficient pace allowed very little time to answer patient questions, educate about chronic diseases, calm somebody’s fears or listen to a patient’s bad joke.

During my training patients would frequently tell me about frustrations with their health care experience. While most people personally liked their physician, many felt disconnected and fed-up with the complexities of basic communication. After hearing the same stories again and again, I started to feel sympathetic towards these complaints. Despite our hard work and good intentions, medical practices often treated patients merely as vessels for billing codes. Doctors seemed to be unwittingly insulating themselves from the very people whom they committed to providing care. And this sympathy was directed towards the fortunate insured people with so-called ‘access’...