It's a new year, it's raining outside, I'm cranky from dieting, and OtherDoc has been out of town for a week. Do I need to provide anymore preface than that? That's right, time to vent!
It's weeks like this that I truly wonder why any sane person would ever consider being in the medical field. Money? Small potatoes compared to other professions. Autonomy? Hardly. Respect? A resounding "Ha! I don't freaking think so!!" I don't know about anyone else, but I am getting sick of hearing about what Op.rah thinks about my profession. This week a patient advised me (and I quote), "Well, Op.rah said to be sure you use the very smallest, um, sepulchre things, and warm it up, too!" Um, did you *really* just say that to me? Really?? Gee, I would have never thought of that without Op.rah's help. Thank you so much for enlightening me, O great one, in how to better practice medicine for my patients. News flash, I know, but I *already* use small *speculums* and I always warm them, too thankyouverymuch. I am already cringing about next week when all the people that watched her s.ex show on Friday call in for urgent, stat libido check appointments. Thanks a heap, O.
It's not just her jumping on the bash physicians bandwagon, though. I see magazine articles and news stories every day instructing people how to "Find out if you have a *good* doctor," or "Things your doctor isn't telling you," or "Medical horror stories, part 374." It makes me physically ill. Like we don't have enough on our proverbial plates, now we have to dispel the media panic surrounding our profession, as well. Why is it that you never see articles about "Accountants gone bad!" or "What your plumber isn't telling you (but should)"? It certainly doesn't help me out when patients come in with printed sheaves of website information instructing me on how to treat their perceived ailment, before I have a chance to take a history, do an exam, or any baseline lab work. It seems that physicians are being reduced to being the "gatekeeper" of health care, instead of the director. "Just shut up and give me what ever test, drug, diagnosis, etc. that I want." What is worse is that we get this from both patients and insurance companies, further restricting our ability to practice our profession the way we are meant to practice. Don't get me wrong, I'm certainly not of the mindset that physicians are omniscient. I practice collaborative medicine, not paternalistic care, but I see the shift even away from collaboration to patient demanded care, and it just isn't right.
This attitude is reflected in the patients each time they call to demand a Di.flucan prescription without coming in for an appointment, over the phone, even if they haven't been seen in the office for 2 years. Or women who delight in paging the physician at 2 in the morning to ask for the list of cold medicines to take in pregnancy because they "lost" the sheet given them in the office, because that's my *job*, you know? It is also rampant in the lay and medical blogospheres. The fear and mistrust of the medical profession is almost painful to read. Sometimes I have to sit on my hands to keep from commenting, lest I perpetuate the "doctors are assholes" perception. Especially in the birthing blogs, where the common thought is that Ob/Gyns are out to fillet every pregnant woman that comes through the door, just because they are evil, scum sucking doctors and not loving, caring midwives. Practicing medicine isn't what it used to be, and I find myself disheartened at the direction our role in medical care is taking. I see my colleagues (and myself) yearning for a job where we can turn off our brains after plugging in our allotted hours of time, instead of taking our work home with us and worrying about people who only see us as drug dispensing/test ordering automatons.
I still have the flashes of what medicine is supposed to be. I'll have a really great pregnancy/delivery with a patient, or I'll do a surgery that improves some one's quality of life, or I'll make a diagnosis that has the potential to alleviate suffering or even save some one's life. It is those few moments that keep me moving forward, doing what I've spent 12 years of my life training to do. Medicine used to be about helping people, but if the changes I see now continue on, medicine will soon be just another "punching the clock" kind of job. If that happens, my friends, then we all lose. Every single one of us.