Doctor Feelbad

From: Helen Dynda (olddad66@runestone.net)
Mon Mar 17 20:49:35 2003


X> Doctor Feelbad.....From the August 06, 2001 issue of New York Magazine.

http://www.newyorkmetro.com/nymetro/health/features/5044/

"Now, announces the New England Journal of Medicine, "many American doctors are unhappy with the quality of their professional lives." The literature on this reads like the intake form at a depression clinic: "increasing marginalization," "discontent," "confused," "angry," "insulted." (Is it any wonder med-school applications are down again this year?) Yes, the doctor is in, but in case you haven't noticed, there's a good chance he's seething. "It's no fun being a doctor anymore," is the way one puts it.

"Once, as Ed Salsberg, head of the Center for Health Workforce Studies, explains, "everything in health care revolved around physicians. They were king of the hill." Accordingly, they were treated in a kingly fashion. Every 50-year-old nurse remembers fetching coffee for a doctor, giving up her chair so he could sit down. The hidden curriculum of medical school is that the doctor is the decision-maker, the brain, the star. But these days, most doctors are just another member of the team. Teamwork is emphasized. Health care is thought to be a system, not something one person does to another. And so doctors have got a new title: health-care provider, a category that includes nurses and lab techs. That alone drives doctors crazy. It's like a demotion. "I'm no health-care provider," says one NYU doc testily, sounding like McCoy from Star Trek. "I'm a doctor."

"Along with power, doctors had autonomy. But now the insurance companies behave like supervisory adults, like scolds suggesting -- implicitly, of course -- that doctors can't be entirely trusted. "You used to have a conversation with a patient and come to agreement," recalls Breslaw. Once, for instance, doctors could prescribe as many MRIs as they felt necessary. Managed-care companies, however, now insist they have to approve such expensive tests in advance."


Enter keywords:
Returns per screen: Require all keywords: