F R O M T H E P U B LISHER
Mad As Hell I'M AS MAD AS HELL... . . . A N D I ' M N O T G O I N G T O TA K E THIS ANYMORE!
The answer is not to leave our profession in droves. Medicine is Our house, and we are taking it back! without paying much attention to the outside world or cues. We ignored what happened when HMO’s came into being. We let it go when “Managed Care” started becoming synonymous with health care. We
Wri t t en by D r. M a rl ene Wu st- S mith, M. D.
didn’t push back when insurance companies started to request “prior authorization” and “peer review” at every turn.
W
We turned a blind eye when the Medi-
hen I first sat I down to
curse. Our brains and thoughts have
care fee schedule became the standard
write this column for the
helped us get to where we are today. In
by which all encounters are reimbursed.
inaugural issue of Physician
order to earn the title of a medical doc-
We didn’t speak up when the volume of
Outlook magazine, I was paralyzed by
tor, most of us we had to sacrifice our
patients seen was rewarded over value.
inaction. I knew what I wanted to
childhood, adolescence and our 20’s to
We ignored it when more and more of
say, but was continuously distracted by
early 30’s to an educational tract that
us came under the employ of corporate
rapid fire thoughts that interrupted the
forced us to delay gratification and give
America and left our private practices.
process of putting pen to paper. The
up our autonomy. Many of us go into a
We didn’t understand the Affordable
average human is estimated to have
tremendous amount of debt to finance
Care Act and, like the legislators who
40,000-60,000 independent thoughts
medical school (to the tune of $250,000
signed the Act into law, we never read
while awake every day. If I had the
to $300,000) even though intellectually
the fine print. As a group, with few
attention span to count or record my
we know that this is not a “smart” thing
exceptions, we kept seeing our patients
own thoughts, I would venture to say
to do. We do it because we care. We do
instead of being at the drawing table
that I am more likely to be in the 60-
it because we want to be physicians with
when Electronic Health Records were
80,000 range! I strongly believe that I
every fiber of our being.
being designed. We did not attend the
am not alone. Most physicians are not
So, what has happened? Why are
Town Halls when healthcare legislation
“average” and are likely to be outlier
so many of us finding ourselves so un-
was being crafted. We did not speak up
companions on the far right of that bell
happy with the profession we dreamed
when we witnessed injustices being com-
curve of thoughts per day. The process
about since we were children? I think
mitted. We assumed it was the responsi-
of deciding to become a doctor starts
most of us ignored what was going on
bility of others, thinking that someone
when we are very young, and requires a
around us. In order to be successful
else had the best interest of the patients
vigorous course of studies and tenacious
doctors, many of us have a tendency to
in mind...and if it’s good for patients, we
determination that never lets our minds
bury our heads in the sand, to take on
would comply obediently in the name of
shut down.
the persona of “the absent-minded pro-
“Doing No Harm.”
The ability to produce all of those
fessor.” We put our “nose to the grind-
What we didn’t bank on is the myr-
thoughts is both a super-power and a
stone” and do what needs to be done,
iad of special interest groups who have
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