While attending in the SICU recently, I was reminded of how fortunate we are. We enter patients’ lives as complete strangers, and are almost always given their trust immediately.
Our patients are frequently in pain, always in some distress, and are often justifiably and genuinely frightened about their illness and their prospects for the future. We spend our time treating patients, easing their symptoms or allaying their fears. It is the essence of our work.
It is very easy to lose sight of that critical kernel at the center of our profession. But in the moment, I find it enormously satisfying and for me many other concerns of the day dissolve for a brief period. I hope you find that satisfaction in your work.
The bad news is that many changes have occurred over the past 20 years that have made the practice of medicine less rewarding. It is less rewarding financially, so nearly all of you are working longer hours for less pay. The resulting heavy workload can grind out the satisfaction that is intrinsic to our profession.
Many of you no longer come to the hospital on a regular basis because it is not cost-efficient and collegiality suffers as a consequence. The never-ending malpractice crisis continues unabated with no realistic hope of resolution in our lifetimes.
The government and the insurance companies are increasingly heavy-handed with their oversight. I expect that will get worse over the coming years, not better.
Obamacare is gradually taking effect with uncertain consequences – except that we will all be paid less. Although, quite frankly, even if the Patient Protection and Affordable Care Act had not passed, we would still earn less in the future. As a profession we failed to control costs and the matter is now being taken out of our hands.
And yet, I’m asking you to work with me in the coming years. Medical Staff members who don’t participate in Medical Staff or Medical Executive Committee meetings or who don’t get involved in their section or department should not complain.
While I recognize that it will be hard and that real conflict is inevitable, I think if we work together, then we will build a system that works for us. It may not be ideal,but it will be better than the alternative. It’s your choice.
Michael Ivy, MD
Chief Medical Officer