Friday, January 29, 2010

The Role of Physicians by Ted Bacharach MD (retired)


The portals of medical care were once open to everyone. Medical care was provided by physicians, there were no intermediaries, those who could afford it saw the physician of “their choice”, the rest, those who couldn’t afford it were seen in the county clinic or county hospital. The elimination of the county hospitals was done smoothly and always the explanations offered were portrayed favorably. It took a while before it became apparent that the indigent no longer were provided for.


Medical insurance provided employment opportunities that had never been seen before. Hospitals once the province of physicians were taken over by administrators. The medical staffs began to realize that their opinions really took second place to “Sound Financial Judgment”. The increased number of physicians employed by hospitals further eroded the influence of medical staffs.


Physicians entering a community were usually required to undergo evaluation by their local medical society. This function was painted as being too self serving and the evaluation of new physicians was not assumed by any organization but hospital administrators could hire physicians of their choice.


Physicians have always been altruistic and assumed that someone else would have the public interest at heart. Unfortunately without input from the medical community the patient now has to see the physician of the insurance carrier’s preference or approval. The indigent without insurance has been able to get some kind of state insurance coverage that makes it financially difficult for physicians to take care of them.


Physicians no longer are judged by ability or capability but are now considered “Generic”. Every surgeon is as good as any other surgeon and all orthopedists are the same. Physicians still, aware of the capability of the specialist to whom they send the patient to will try to circumvent the insurance company’s list. Unfortunately the physician who does this too often is not kept on the list of approved physicians.

Control of medical care at every level has been taken away from the physician. Even the State has gotten into the act and now the physician must see the patient within a specified period of time.


The clock can’t be turned back. Unless the medical profession becomes more assertive they can join the assembly line workers in so far as any say about the services they provide. Administrators may understand economic problems but when their solutions have an impact on the quality of care it behooves the physician to be heard. The overall quality of care should be determined by the physicians who provide the care.


Physicians still play a major role in the provision of medical services and whenever possible should realize that they must work hard on preserving a major role in the way medicine is practiced.

3 comments:

Michael Guzzo said...

Unless the medical profession becomes more assertive they can join the assembly line workers..

Or an assembly line pharmacist.

Pat said...

Ted, doctors were altruistic, and in so being betrayed themselves and by extension, their patients. The proclaimed selflessness and sacrifice of altruism are lies that physicians told themselves in order to inflate their own self-esteem. As opposed to philanthropy, wherein ones' giving is a reward to the giver who is NOT sacrificed to the good of the many, altruism set up doctors to be apologetic for themselves and their own worth, which was henceforth defined only by others.
And so now we are and shall remain, a commodity. The only power we have left or will now ever have, is the power to refuse to work. When society began to attack us with alacrity and moral self-assuredness, and we accepted it, we became nothing more noble than any other services provider. While being a physician may be worth more to a given individual, with respect to our relationship with the rest of society, it's a job.

Mark said...

Medical negligence, in legal sense, is the act or failure to act in accordance with the accepted standards of the health care practice. In many occasions, these performances or omissions have been the cause of numerous accounts of personal injuries and deaths in the United States.

Medical Negligenceis much more than a doctor making a mistake. To prove that the doctor was medically negligent, your solicitor must also show that in making that mistake the doctor or dentist provided a standard of care that was unacceptable by the standards of the profession.