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Reflections (continued)
limitations imposed by institutions, employers, or insurance companies. As physicians we are expected to provide “excellent, expeditious, and affordable” care for a new patient in 30 minutes and follow up care for an established patient in 15 minutes, not counting electronic medical record (EMR) time. No physician can adequately care for and appropriately document the history and physical with such time limitations. To increase institutional “efficiency” or profit, many physicians are being pushed to see in- creased numbers of patients, steadily eroding quality of care.
I hope that my lament and assessment of current training and opportunities for practice resonates with you, my colleagues, and others. Most of us become physicians because we have an internal drive to learn and use our talents to improve the health and quality of life of others. This innate characteristic is awe- some and even more extraordinary in that we sacrifice so much of our youth to obtain this goal. The more I learn about life dur- ing residency, the more time I question my decision to become a physician. No one ever told us about the “modern” physician’s responsibilities to be “productive,” reach ideal numbers of rela- tive value units (RVUs), excessively document anything and ev- erything on EMR, complete continuing education and all sorts
ofothermandatoryprogramsonline,scheduleappointmentsand tests, review laboratory results, and many other things, all at the same time while worrying about a litigious society driven by Yelp and Google reviews.
What can I do? What can you do? Do we acquiesce to the pres- sures this kind of medicine dictated by bureaucracies, whom lo- cal, state, and federal governments, hospitals, medical schools, private companies, insurance companies, and others are institut- ing, or do we try to reinvent medicine to allow us to spend time with patients and give them the quality care commensurate with our training. It’s up to all of us, you, me, all of us, no matter where and how we practice.
The opinions are that of the author and not of the University of South Florida or the University of South Florida Morsani College of Medicine.
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HCMA BULLETIN, Vol 66, No. 1 – Summer 2020
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