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Health care in turmoil: costs, shortages, and pandemic strains

Health care in the United States is in a state of turmoil. Many Americans are struggling to pay for health care. Even if they have health insurance, many have to pay high out-of-pocket copayments and, in the end, feel that what they do pay for is not worth the cost.

As a result of the COVID pandemic, many health care workers faced mounting mental health crises from burnout, physical and mental harassment, and lack of support from employers. This was reported by the Centers for Disease Control on November 3, 2023.

In addition, the ever-increasing assignment of administrative burdens, inadequate support in medical practices and health systems to lessen obstacles in day-to-day tasks, circulation of misinformation on social media, and political attacks on the value of medical science have all had a profound effect on the practice of medicine. The reduction of medical reimbursements from the government and third-party interference from pharmaceutical and insurance companies have further complicated the situation. All these factors have contributed to the dissolution of the patient-physician relationship and health care as we once knew it.

Many physicians and nurses have taken early retirement or left their professions for less stressful positions. As a result, the United States is experiencing a shortage of both primary care physicians and nurses. The shortage of physicians is also extending into some specialty areas, resulting in several-month wait times to secure an appointment slot. This has caused people who need medical care to crowd into emergency departments, impeding the care of those with serious illnesses.

I would like to have a straightforward talk with those considering entering medical school, those who will soon be entering residency programs, or those family medicine physicians who have been in the field for a while. In a few words, we, your patients, need you; our very lives depend on it!

As patients, we assume you have the academic credentials for admission into medical school and to secure your Doctor of Medicine degree. However, being a great primary care physician takes more than receiving good grades. It takes heart and compassion for the job.

Throughout your professional career, you will deliver difficult and life-changing diagnoses such as cancer, miscarriage, and autoimmune diseases for which there are no cures. Will you look at the computer screen as you say the words, or will you look into the eyes of your patient with concern and empathy?

Will you be there to walk beside your patient, as a partner, in helping him/her improve their health? Are you ready and willing to educate your patients so that potential illness/disease can be prevented, supplying both information and encouragement?

Are you using the full scope of your medical education and training to determine the root cause of your patient’s health issue? Or are you sending your patient off to an assortment of specialists who order numerous tests when you could have done the job yourself, saving your patient excess stress, anxiety, and financial hardship?

Are you willing to see your patient as more than charts and numbers on Epic? Can you see them as someone who has a family who loves them dearly or, at the other extreme, has no one who cares whether they live or die besides you?

Do you view this job as a “calling”? Does this mean that you not only “talk the talk” but, more importantly, “walk the walk”? With the burdens and stresses of the job, if your commitment isn’t a strong one, your resolve will suffer, and you will be looking for a way out. This affects not only you but also your patients, who have come to trust in you.

This profession is not for the faint of heart. There will be joy, and there will be sadness. There will be times when you feel no one hears you or cares how difficult your job is. Over the years, as a patient, I have seen physicians who are truly committed to their patients and, at the same time, can balance their professional and personal lives. In these times of corporate health systems, this is not an easy task. Much of your daily routines are dictated by those who sit in board rooms rather than exam rooms. Those individuals who can achieve this delicate balance can draw satisfaction from the relationships and trust they have built with their patients and colleagues.

As patients, we appreciate primary care physicians who are genuinely committed to helping us lead healthier lives. We understand the dedication and challenges that come with this profession. However, we need assurance that we won’t be seeing a “new face” at our next appointment, especially when we have already established a level of trust and comfort with our current physician.

If I had a magic wand and could eliminate all the intrusive interference that harms the doctor-patient relationship, I would have used it many times. Unfortunately, that only exists in fairy tales. Until then, both patients and physicians must continue to speak out and have their concerns addressed. Silence and inaction have only led to the practice of medicine being placed in bondage. The chains must be broken: Lives depend upon it.

Michele Luckenbaugh is a patient advocate. 


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