Who Broke The American Healthcare System?

Healthcare is a hot topic in the media these days. Yet, few people are satisfied with the way it is working. Many claim that the American healthcare system is broken. Patients are increasingly frustrated with finding a doctor, getting tests and medications they need, and paying for out-of-pocket expenses. Numerous doctors are disenchanted with their career choice, and burnout is a common complaint. Frequently, doctors are now looking to retire early or for alternate career paths. Treating patients has become unfulfilling for many due to administrative burdens, increasing government regulations, and overbearing insurance over-sight. Doctors fight daily to get procedures and medications covered that their patients need. Most often, the battle is with someone who is not even a doctor or has any clue about the patient. These daily battles become wearing. Additionally, doctors now have to fight on a more abundant basis to get paid for services they provided. Their incomes are stagnant or shrinking while overhead costs are soaring. Increasingly, doctors are selling out their practices and joining large groups and hospitals.

“When I go in the exam room and close the door, I face my patient and am again reminded of why I became a doctor: to alleviate suffering.”

Many people look to put blame on doctors for the broken healthcare system. Yet, it has been years since doctors truly had any control over it. More often these days, doctors are treated like pawns and servants, our independence and integrity being worn away and questioned. But, who really is to blame for the broken healthcare system?

1. Commercial insurance companies who have no oversight and profit from denying services to patients. I have seen more and more diagnostic tests and medications being denied since I started practicing approximately 15 years ago. All too commonly, procedures and medications require prior-authorizations. This is time-consuming and costly. Insurance companies employ people just for this task. Some get bonuses for cost containment. The executives of these insurance companies make obscene salaries. Meanwhile, they are tying doctors hands from doing what is needed to provide patients with the best quality medical care. Medicine is now driven for cost-containment rather than quality thanks to the for-profit insurance companies.

2. The government has been placing increasing burdens on regulating physicians. One good example of this are the Meaningful Use EHR incentives. While we are now able to get a bonus for qualifying for implementing an EHR system, soon doctors will be penalized for not complying. The process to get qualified is onerous and truly not meaningful for doctors. Doctors spend time checking boxes to record metrics so that we don’t get penalized. We rather use that time to devote to our patients.

3. The tort system has also had a disastrous effect on the healthcare system. While patients should have the means to be compensated for obvious negligence and malpractice, this is not what is occurring. Frivolous lawsuits make up a great majority of cases. Patients often threaten the doctor with lawsuits if we do not give into their demands. Doctors pay large premiums on their malpractice insurance for just this reason. For some specialties, such as obstetrics, it has become too expensive a premium to continue in their specialty. Much medicine is driven by the need to avoid getting sued. Not only does this drive up costs, but it erodes the trust between doctors and patients. There is a big need for tort reform.

4. Groups like the American Medical Association who pander to politicians more than anyone else. When they say they speak up for doctors, the public listens. However, many doctors feel that their voice is not our voice. They are not listening to doctors’ concerns about what is needed to improve healthcare in this country.

While the healthcare system pushes forward in need of repair, doctors continue at what they do best: treating patients. Few people became doctors for the income. Many claim that doctors are driven by profit, yet this is not true in most cases. The vast majority truly care about our patients and want to offer the highest care for them. When I go in the exam room and close the door, I face my patient and am again reminded of why I became a doctor: to alleviate suffering. And no matter how broken the system becomes, that person in front of me is truly the most important thing that matters, and I will continue my daily fight to get the best for them.

The original article can be found on Dr. Linda’s blog here.

Dr. Linda Girgis MD, FAAFP, is a family physician in South River, New Jersey. She holds board certification from the American Board of Family Medicine and is affiliated with St. Peter’s University Hospital and Raritan Bay Hospital. Dr. Girgis earned her medical degree from St. George’s University School of Medicine. She completed her internship and residency at Sacred Heart Hospital, through Temple University and she was recognized as intern of the year. Over the course of her practice, Dr. Girgis has continued to earn awards and recognition from her peers and a variety of industry bodies, including: Patients’ Choice Award, 2011-2012, Compassionate Doctor Recognition, 2011-2012. Dr. Girgis’ primary goal as a physician remains ensuring that each of her patients receives the highest available standard of medical care.

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