Because our healthcare system is so full of holes, it’s tempting to assume that all its participants are jaded by the push for expensive tests, surgery, and pharmaceuticals. Of course, that is a dangerous assumption. The system has many committed professionals, some of whom are highly concerned about the direction of healthcare. It’s just that we don’t get to hear their voices, since the system doesn’t encourage dissent.
One of these workers wrote me recently–a pained message from a reader of this blog, reaching out for advice, and reassurance. Because of its sensitivity, I can’t reveal all the details as to the writer’s identity. (I cleared with this individual that it would be okay to publish the basic story.)
"I’m wondering about the state of my life," the note began, explaining the individual’s responsibilities for overseeing specialized medical services within a health care facility."I am one of those people making their living from this horrid mess of pseudo-healthcare, reimbursed by third-party systems. It’s a strange place to be for someone with my sort of beliefs and lifestyle.
"As someone who advocates for (patient friendly healthcare initiatives) I have become somewhat of a pariah here at work. Fortunately, because I am a gnat flying amongst a herd of tyrannosaurus rex, I am viewed more as an ‘amusing counter-culturist’ than a dangerous infiltrator (a safe place to be), but the incongruity of my position never escapes me, and frankly (personally speaking) it causes continual cognitive dissonance. I long for escape, but feel tethered.
"There are more than a few like me out there. I found that out when I began posting my health rantings on a … (professional) listserve. Most of my comments are neatly deflected by…my peers, but occasionally I do receive responses privately (i.e. not through the published listserve) expressing agreement, attached to timid language like ‘I don’t want to be seen as bucking the system, but…’
"This rotten system is so big, so entrenched into our culture and business, that the only chance we have for meaningful change is through (its) collapse. That may be closer than we think…"
I advised this individual to consider changing jobs, possibly trying to work at an integrative health facility, which is the healthcare system’s equivalent of Whole Foods, springing up in many metropolitan areas. These facilities combine holistic and traditional medical approaches, though they are part of the reimbursement system that screws up priorities. Aside from that, I didn’t have a lot to offer, except that this individual should take care not to rock the boat too hard, at least not before securing other employment options.
This individual’s story resonates especially strongly because, unlike most professions, healthcare is supposed to be about compassion and caring. When it isn’t, the most committed become understandably disillusioned.
Interestingly, there is another country with similar problems: China. As it pursues capitalism with a passion, it has modeled its healthcare system on America’s. Today’s WSJ has a profile about the ostracism, including physical assault, of a physician with the courage and conviction to stand up to the system by preaching preventive care. Other doctors harass this physician because he is viewed as costing them profits from excessive reliance on high-tech tests and drug prescriptions. Of course, in the U.S., we aren’t so crude about our techniques of repression. The Chinese have a few lessons to learn .
Recent Comments