Why all this now?

Physicians have been surpisingly quiet in the past during health care debates. There are many reasons for this. First, we are extremely busy. We spend over 12 hours a day (sometimes 18 hours a day) working, and any extra time is usually spent with family and friends. Very rarely will you ever find a doctor doing nothing for extended periods of time. It just isn't in our wiring to be sedentary. Most of us are "type A" personalities, and we feel guilty sitting around. While we spend so much time working, that gives us less time for advocacy. Going to Washington, D.C. to speak with congressmen is hard work, and it takes massive coordination. It's rare for us to have multiple days off, and even more rare for them to be in a row.

Second, doctors are taught to be as sure as we can about things, but we've seen nothing is ever "black and white" or clear cut. Unexpected things happen all the time, and we can't tell the future any better than anyone else. It may be a product of our culture, but that makes us not as vocal when asked about our opinion. We try to be sensitive to others, and as I've said before, if this were a completely one-sided issue, everyone would probably be on the same side. These issues, however, are multifaceted and we often have to concede one point in order to obtain another. Just like voting for a president often feels as though you're voting for the "lesser of two evils," health care legislation is usually loaded down with "pork," special interests, and other uneccessary provisions. We also try to be sensitive to others' viewpoints. It just wouldn't be very "kosher" for a physician to get in a debate with a patient during an appointment, and would actually be counterproductive. A patient has probably waited a long time to see their doctor for a medical issue, and it takes time to get the correct diagnosis and treatment. It would be wrong to spend that time on politics, or to take that time away from someone else who needs treatment.

Third, law isn't our area of expertise (just like medicine isn't the area of expertise for lawyers and politicians), and we really don't like how it has intruded on our ability to practice medicine. All doctors are familiar with malpractice, and it's like driving a car: you're likely to get into an accident someday. It is the norm for a physician to be sued at least once in their lifetime. For that reason, we quietly despise getting involved in law. Furthermore, part of the push for physicians to become specialists is that we are "type A." We want to be good. We want to know something really well. If we're not trained in it, we likely don't want to comment on it as much because we don't want to be incorrect or wrong. If you spend any time watching TV, you can see the "beat down" residents get during their training (on a side note, the TV show Scrubs pretty much hits the nail on the head).

On a personal note, I am absolutely opposed to "lining the pockets of politicians." I believe a person does that "right thing" because it is the "right thing to do." It makes me furious to have to pay someone for my rights, or the rights of my patients. Lawyers knew of the conflict of interest created when money gets involved in patient care. For that reason, multiple laws have been passed to prevent money from being the determining factor of someone's health. In every other field, a person can receive monetary or tangible incentives for their business. It is not uncommon to go golfing, to a show, or on a vacation in other businesses. It is unethical in our business. Laws were passed to keep pharmaceutical companies from "buying off" their doctors prescribing practices. I myself was opposed to getting freebies from pharmaceutical companies before rules were passed by residencies prohibiting such a practice. Furthermore, physicians hire office staff for their accounting, because we don't like getting bogged down in the billing aspect. We are much more interested in proper diagnosis and treatment. Call it a weakness, if you will, but wouldn't you rather your doctor spend time treating your illness correctly instead of cashing his checks? For goodness sakes, we go on missions trips ALL THE TIME to give free health care to people- on our vacation time!


Activism organizations have been set up to represent physicians on these important issues. Each of our professional affiliations have an advocacy wing. Unfortunately, those organizations don't always represent the views of their constituents. Sound familiar? Congress seems to have the same problem. There is nothing more infuriating than your representatives not representing you, and instead representing their own interests, agendas, or political goals.


I chose to finally blog about this now because this is a pivotal time in health care for our country. There are definitely important issues to address and, if we are not heard, the United States may go down a path that would take years if ever to repair. I hope my opinion gives all you readers a greater perspective from a physician's viewpoint on the situation we face in the American health care system.