Probably most of the people who choose to become doctors or nurses do so because they want to help others.  For the doctors and nurses who have this as their reason for being, these are difficult times indeed.  More and more they are being forced to treat patients in a way that maximizes profits regardless of whether that treatment may be in the patient’s best interest or not.  This clash between the ideals of the health care professional and what they are being required to do by their employers is causing great emotional distress and driving many of the most idealistic from the profession.

Physician Burnout Costs The U.S. Health Care System Billions Each Year :  Shots - Health News : NPR

Moral injury is the term applied when a person does something that conflicts with their moral compass.  The term has its origin in warfare where people sometimes find themselves doing things that repulse them and horrify them.  More and more often, it is being applied to doctors and nurses who cannot reconcile their obligation to their patients with the requirements laid down by their employers.

A growing swath of the health care industry has been taken over by private equity, which demands returns on its investment.  Private equity has been buying up doctor’s practices, clinics, hospitals, and home health companies.  Today over 70% of doctors are salaried employees, who must answer to administrators and executives.  That is a shocking number and the consequences to the health care system are profound.

Doctors increasingly see themselves, not as advocates for their patients, but as cogs in a larger machine that eats patients up and one end and spits them out at the other.  They see that it is no longer whether they have helped their patients that is important but how many patients did they see, how many tests did they order, and how many value units did they create.  Most of these doctors don’t mind working hard to serve their patients, but that is not what is happening today.

Our health care system, which was never a model of fairness and equity, is becoming less fair and more inequitable with every passing day.  If you have money, you usually have health insurance.  If you have health insurance, you are a potential cash cow that private equity can milk.

Doctors who complain are being treated like low level employees at Starbucks who complain.  They are being shown the door or disciplined in some way.  Some emergency room physicians who have raised concerns have found themselves looking at reduced hours or no work at all.  The result is that some doctors and nurses are looking to unionize to protect themselves.

In the years after World War II, the American Medical Association fought hard against the idea of universal health care.  Their stated reason was to preserve physician independence.  As the old adage goes, “Be careful what you wish for.”  Much to the detriment of society as a whole, we do not have universal health care and most doctors have lost their independence anyway as their employers ramp up their demands for profits.  Something needs to change.

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