America’s civil war on doctors (by Rebekah Bernard, MD)

I recently saw the movie, Captain America: Civil War. If you haven’t seen it yet (no spoilers), the United Nations decides that because of civilian fatalities during previous Avenger battles, the world would be safer if all superheroes voluntarily subjugate themselves to the authority of an organized government body.

Sounds good to some of the Avengers; after all, innocent people have died, and maybe some form of supervision will minimize collateral loss. Captain America, on the other hand, refuses, believing that his own conscience combined with his super-hero skills and training make him more qualified than any external force in deciding how to handle the “bad guys.”

As I watched our brave Avengers criticized and excoriated for the damage that they have ensued on society during their attempts to do good, I couldn’t help but find comparisons to the way that doctors are treated in our current health care system.

Read the headlines: Like the Avengers, doctors are shown wreaking havoc on society. Medical errors (and therefore doctors), are the third leading cause of death in the United States. Physicians are responsible for America’s opioid crisis. And why even use doctors when nurses can provide the same or better care than doctors do with less training? Everywhere you look, doctors have become society’s favorite whipping-boy.

Never mind the fact that physicians enter the profession with the best of intentions, sacrificing years of our lives to education, including an ongoing struggle to stay abreast of the latest scientific research, deferring family life and friends, and obligating ourselves to thousands of dollars of debt.  Never mind that doctors have had to fight harder as our enemy grows stronger with the epidemic of obesity, diabetes and the aging of the population. Forget the good work that doctors have done, the lives that have been saved by both intervention and prevention of disease.

And never mind that doctors hurt and suffer along with our patients. Because even when doctors are trying the best that we can, things go wrong. We get tired. We make mistakes. And when we do, our hearts ache, we shed tears, and sometimes we feel so much guilt that we can’t go on. Sometimes we even kill ourselves.

So how is society to reconcile the conflict that arises when despite doctors’ best efforts, people will suffer and die?

Up to this point, American’s reaction has been very similar to the UN solution to dealing with the Avengers: Let’s form a large government body to supervise doctors, laying out thousands of pages of documents telling them what do to, and then criminalize physicians when they don’t follow the “rules.”

Let’s create burdensome systems to allow that government body to keep a medical scorecard, making up the rules as we go along. Make doctors buy expensive computer systems, and then become typists and data entry clerks to make it easier on government reviewers.

Let’s keep doctors in their place by calling them providers and making them fight for every payment. Don’t forget to subject them to a needlessly expensive and time-consuming process of certification in order to ply the trade that they have worked so hard to achieve.

News flash: This abusive system isn’t working. Doctors are burning out, quitting, retiring, and forgoing primary care specialties. And the biggest loser of this decrease in physician morale are Americans, every single one of us, as the best and brightest in health care quietly slip away.

We need to change the paradigm. Stop this civil war in medicine, and let doctors get back to what we truly do best: caring for our patients. Let us police ourselves with our own medical boards, and help us to cut out the administrative burdens that affect our time with patients.

Please believe that physicians have more training and skills than any group of MBA graduates and career politicians. And like the Avengers, know the vast majority of doctors will follow their conscience to always do what is right.

Rebekah Bernard is a family physician and the author of How to Be a Rock Star Doctor: The Complete Guide to Taking Back Control of Your Life and Your Profession. She can be reached at How to Be a Rock Star Doctor.

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