Where have all the Doctors gone?

“The accumulation of all powers, legislative, executive, and judiciary, in the same hands, whether of one, a few, or many, and whether hereditary, self appointed, or elective, may justly be pronounced the very definition of tyranny.” ~ James Madison, Federalist Paper 47.

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This post, by EM Physician (a blog I read frequently, and enjoy) made a few statements that got me thinking. But before we get started, someone made a comment I feel compelled to answer…

Not even going to touch the rest of your comment, ucalcal, but this?

Where are the nurses on ensuring enough paramedics are available to provide a quick response to 911 calls so sick individuals get to the hospital in time to be saved? (emphasis mine)

WTF? Like the nurses have control over the paramedic companies. You are talking out of your ass, man. Good grief.

That said, the reason nurses are catching so much flak here is because they ARE unionized. Squeaky wheel gets the grease, as they say. The bigger question is, why isn’t everyone else fighting, too? It isn’t the nurses’ fault that they are biased in favor of nurses. In Federalist Papers No. 51, James Madison said, “Ambition must be made to counteract ambition.” But where is the ambition of the docs, radtechs, etc?

If you want to blame someone, start by blaming yourself. Docs are seen as weak because they are weak. Pushed around for the last five decades by an increasing mound of paper, allowing the insurance corporations and government bureaucrats to dictate patient care. Then, someone (nurses) stands up and says, “Hey, we’re not going to take this anymore!” and you cry “foul”? You cast all the blame on the nurses?

That’s crap, and you know it. Get your fellow docs to wake up and DO something. It’s not good for one voice to dominate in any arena, but if no one else will speak up…I guess you’ll have to take what you get.

Oh, and about the quote? I think “tyranny” could justly describe the amount of low- and mid-level government interference in healthcare. We’ve got so much paper to dick with that patient care is prime for a raging blaze.

Look at Yellowstone National Forest. Ever heard of “controlled burn“? Started in 1972. Burning, when done frequently and responsibly, eliminates the underbrush, stimulates growth, removes deadwood, etc. All good things for a forest. When natural burning is eliminated, you get a strangled forest.

That’s the picture of the healthcare system today–massive, overgrown. I don’t even like that phrase: healthcare system. It’s not health care. It’s sick care, or pretending-to-be-sick-so-I-can-score care.

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So, what’s the answer? I don’t have one. But I do know where the blame lies: with all of us. With the nurses, for pushing our own interests without an eye for the effect on the system.

With doctors, for ignoring the problem and hoping it’ll just go away.

With other professionals (radtechs, pharmacists, paramedics, etc.) for acting like the problem doesn’t include them.

With specialists, for opting out WITHOUT speaking up to the administration and the government.

With administration, for introducing/implementing policies and procedures willy-nilly, refusing to listen to staff complaints, and passing the buck.

With the numerous “associations”, who take your money but don’t do jack.

With the government, for doing a poor job of governing anything, and printing paper instead, mandating changes without looking further than the next election cycle.

With insurance company CEOs/CFOs/majority stockholders, who screw everyone and spend summers in Montana with Chuck.

And, lastly, with the patients, who are the crux of it all. Without patients, the system doesn’t exist. They are, in a word, essential. Yet they are unorganized, lacking advocates, because they don’t know what they need…which is where doctors and nurses come in. Yet so far, only the nurses have made their voices heard.

So.

Where have all the doctors gone?