When someone needs their hip replaced, they see an orthopedic surgeon; if someone has cancer, they might see an oncologist; if a woman is having a baby, she’ll probably go to an OB/GYN. This being said, contemporary views on healthcare are drastically different than how they used to be. As medicine and its practices are improving, the dissatisfaction of patients is rising from a plethora of issues. This frustration for people seeking the care they need generally doesn’t stem from doctors being inadequate in their respective field, but rather the lack of compassion in the physician-patient relationship. Explicitly, the cause of this apathy is not the fault of the doctors alone, but the healthcare institutions that breed from consumerism as well as physician manipulation and overhaul.

Bang For Your Buck

The simplest approach at which healthcare is discussed is the drive for profit. Today, many people prioritize their money over their health. In conjunction, so do hospitals in the idea that patients aren’t careseekers but that they are customers. Martyn Lewis would agree that, maybe unknowingly, patients are always just a buyer the hospital needs to sell for.

As a proclaimed behavioral economist, Martyn Lewis views hospitals simply as another revenue chain for maximizing profits and investments. He believes that while hospitals have the duty to serve those who are in need of medical attention, they also function as an underlying business. His key points are most people are uninterested in the products themselves, but rather the end-goal associated with said product and little things unrelated to the treatment are what build patient satisfaction. Claiming it as “the DNA of the buying journey,” Lewis supports his statements by describing a patient in need of a knee replacement (3:30). He says, “buyers actively do not want to buy surgery” due to fear and anxieties over possible complications or postoperative difficulties but eventually relent because they are focused on “what that purchase is going to enable them to do” (4:27 & 8:18). He goes on to explain that instead of giving advice and the run-down of a procedure in the first consultation, physicians should rather “actively navigate [the patient], support [the patient], and manage [the patient] through that journey” to target and secure the sales pitch (6:03). Furthermore, Lewis adds that little things like a receptionist with a nice demeanor or anesthetists giving patients better pillows is what triggers people to refer friends and/or family to see a certain doctor. He asserts that small triggers are what push people to return to a doctor which in turn helps the business.

The human mind is full of little quirks that take time and practice to acknowledge, recognize, and take advantage of. Much of healthcare today utilizes strategies like Martyn Lewis’s to exploit issues within patients and force them to feel pressured to fix. The idea of creating a pitch to someone actively avoiding an operation or treatment is taking advantage of patients who may not require anything at the moment. The heart of the pitch revolves around the desire “to be healthy… to be without pain” even when there isn’t enough pain to warrant an operation (8:54). In similar fashion, health officials often prey on small pieces of each operation that don’t affect patient outcome or well-being. For example, a nurse changing a pillow is what Martyn Lewis calls a trigger to trick a patient into becoming a referral system. This not only diminishes the jobs of hospital staff, but also diminishes the focus on the patient. Turning a blind eye from the patient’s long-term recovery and onto the mundane task of getting a better pillow is not only a nurse’s job already, but clouds the patient’s own opinion on how they feel their operation and recovery has gone. Despite this Lewis argues that while this business model can currently detract from a physician’s focus on the patient, it will help both doctor and patient decide on the best option for the patient’s health when the patient can be confident in the operation they purchase.

Integration of Technology in Medicine

Relatedly, as society expands further into technology-based workstyles, so do health institutions. Physicians now have electronic medical records (EMRs) compared to carrying binders with medical sheets. These EMRs improve many processes documentation of patients such as filling prescriptions, connecting doctors with updated records and allowing them easier access when collaborating, and make sure doctors get paid correctly. Although they are helpful in many ways they can slow down the workflow of physicians, says Rick Vaughn, the Chief Medical Information Officer of SSM.

The difficulties of integrating technology into the world of health is caused by multiple reasons, Vaughn asserts. He states that adaptation and comprehension of programs “is sort of a bell curve” in which some doctors are apt and others have severe challenges (4:40). In like manner, he says the technologies that are possible to integrate either don’t exist or can be inefficient themselves and makes the EMR the best choice to document patients at the moment. The development and use of the EMR, as Vaughn proclaims, “required excessive documentation—required physicians to do things that have nothing to do with taking care of the patient” (7:37). Moving forward, thoughts of utilizing artificial intelligence have become more of a reality now with increasing knowledge of AI technology. The hopes that “EMR must evolve into an intelligence agent that’s going to work hand-in-hand with the provider” are what Vaughn declares to be the ultimate goal for physicians to help focus their full attention towards the patient (9:23).

In some workplaces, technology can make an astounding difference in performance. The problem with incorporating electronics into a profession full of handwritten notes is that technology hasn’t evolved fast enough to efficiently service physicians. Provided that doctors are given technology that isn’t advanced enough anyways, they are forced to do the same job as they did before but learn the program, interface, and data systems in EMRs on top of added documentation for billing and coding. Equally, doctors are unhappy they are overburdened and forced to stay late to finish records and this can cause burnout that is visible to patients. For this reason, Vaughn positions himself on the side that until technology can improve, like AI working with the physician and patient, there will be very little advancement in the pairing of medicine and technology.

Privatized Equals Pain

To further doctor dissatisfaction, running a private facility for primary care, for instance, has become largely unavailable due to the fiscal risks a physician has to take. With high overhead costs and typically low reimbursement, the benefit is rarely worth the cost. In addition, hospitals have incentivized doctors to join their alliances which causes a further cycle of the hospital monopoly.

Many primary care physicians feel, like Gillian Griffith, O.B., that they “don’t think independent practice is really an option” anymore (Griffith). With 22% of medical residents saying they didn’t even plan to own or co-own a private facility in a 2016 study, insurance companies are often to blame for the lack of desire to own a practice (Johnson). Due to EMRs many insurance companies can search records to deny coverage. In the same fashion, being an administrator for an independent practice is an incredible burden financially and emotionally and is “a leading contributor to physician burnout” from bureaucratic paperwork (Johnson). However, the drive to open an independent care facility is being replaced with the option of joining an alliance in hospital. This allows doctors to keep in much better communication with others, as well as let them seek other paths in their careers. For example, hospitals allow doctors to further pursue education. In Anna Goldheim’s, M.D., case, she was able to earn her master’s degree in public health to “obtain the skills necessary to improve the health system in which [she] will deliver care, and to explore opportunities outside of clinical medicine, should [she] decide to balance clinical medicine with an allied job” (Goldheim). Similarly, Ishani Ganguli, M.D.,  can do research in healthcare policy while balancing clinical work and teaching at Harvard Medical School and asserts that “working for an institution enables her to wear multiple hats and ‘leads to greater mobility’” (Johnson & Ganguli). Correspondingly, many businesses are looking for physicians to give them credibility in the healthcare industry and this leads many doctors to follow non-traditional pathways in their careers.

As caregivers stray further from the norms of private practice, hospitals and corporations have created more opportunities for diversity in their careers. This being said, the problems within hospital capitalism will not change for the time being, and encouraging doctors to become more entrepreneurial further pushes the current status quo to create the highest profit. This circularity of the process leads to more capitalistic approaches in medicine that overall do not benefit the public. While private practices are not the most optimal pursuit for doctors today, they are shown to be a good option for the public because they have deeper patient connection and are more patient-health oriented.

Doctors are People Too

Healthcare is very heavily focused around the caretakers, but the caregivers can often go unnoticed. Physicians can often be seen as disconnected and cold to patients, but this is often not the fault of the physician. As noted by Angeliki Kerasidou and Ruth Horn, “the open expression of feelings is perceived as weakness,” and patients do not desire fragility from the person responsible for helping them overcome their own weakness (Kerasidou & Horn). This mentality forces doctors to lack empathy and neglect their own emotions in order to be medically and scientifically objective which causes “emotional exhaustion, burnout, depression or even attempt suicide.” Estimated per year, over 300 doctors commit suicide for a population of 100,000 compared to 40 people out of 100,000 in the general population (Kerasidou & Horn). These astronomical numbers are argued to stem from the mental duress physicians have to undertake on the daily, such as working 80 hours a week while balancing a family life, dealing with newly implemented systems, or simply being burned out from the lack of patient-wellness oriented care.

As has been noted, physician health is as important as patient health because health is a common theme central to all individuals. Their jobs are highly stressful alone, but adding other stimuli to deepen their hole causes a deprivation of emotion that is also deemed necessary by society. This apathy, in turn, increases the likelihood of doctors forming negative habits or mindsets that can ultimately lead to suicide. The importance of the argument made is not to preserve the number of doctors in the workforce but allow them to be patients as well, and seek help when they need it. The problem, however, is that the healthcare industry has put many roadblocks in their path of medicine that doctors often feel they are unable to do their true purpose: care for their patients.

How Does This Define Healthcare?

All things considered, there are many problems with healthcare, in general, resulting in the conclusion of patients who are often unhappy with the care they receive. On the superficial level, this can be attributed to the lack of doctors in the workforce, or even the lack of character amongst the staff. But when looked at a deeper level, the root of patient dissatisfaction arises from the pressure put on the doctors from their work environments. Hospitals have forced doctors to be a piston in the machine of hospital consumerism in order to sell treatments and operations and the argued solution for this is create a larger private sector for caregivers. This model is controversial because it is currently overtaxing for doctors, but once implemented smoothly it can help better inform the patient of their purchase and decision. At the same time, overhaul from bureaucracies and insurance companies deters the doctors from pursuing a privatized path of medicine in which they can control their own schedules and manners of patient care. Coupled with a physician’s inability to leave the hospital systems, technology’s adaptation into the medical field has been subpar by creating further complications in how doctors keep records and get paid. The argued solution to this is finding an improved form of voice recognition software or even AI to record and process data. Nonetheless, one of the most direct effects on which the patients view the quality of their care is the conduct of the doctor. Patients want their doctors to be confident yet personable, but the consequences of how administrators and technology affect not only their demeanor towards their career but their emotional well-being too. The added workload of the aforementioned EMRs and learning how to sell care is a large part of physician apathy and burnout. In brief, this cycle of monopoly to apathy is the underlying reason for patient complaints.

Works Cited

Pitt, Alan. “Why Don’t You Eat Your Vegetables. What Can We Learn From Sales?” Healthcare Pittstop, 6 Jan. 2019, healthcarepittstop.com/why-dont-you-eat-your-vegetables-what-can-we-learn-from-sales/.

Pitt, Alan. “‘We Have Plenty of Physicians- We Just Have to Stop Asking Them to Do Silly Things’ Rick Vaughn- Chief Medical Officer of SSM.” Healthcare Pittstop, 14 Sept. 2017, healthcarepittstop.com/plenty-physicians-just-stop-asking-silly-things-rick-vaugh-chief-medical-officer-ssm/.

Shea, Julie. “What’s Killing Private Practice? | Healthcare Careers.” Clinician Today, 4 Jan. 2017, cliniciantoday.com/whats-killing-private-practice/.

Johnson, Megan. “Young Doctors Want Jobs, Not Partnerships.” AthenaInsight, 1 Mar. 2018, www.athenahealth.com/insight/young-doctors-want-jobs-not-partnerships.

Kerasidou, Angeliki, and Ruth Horn. “Making Space for Empathy: Supporting Doctors in the Emotional Labour of Clinical Care.” BMC Medical Ethics, BioMed Central, 27 Jan. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4728886/.

Farmer, Blake. “When Doctors Struggle With Suicide, Their Profession Often Fails Them.” NPR, NPR, 31 July 2018, www.npr.org/sections/health-shots/2018/07/31/634217947/to-prevent-doctor-suicides-medical-industry-rethinks-how-doctors-work.