Medical Apocalypse

February 7, 2013

businessman with gas mask watching TVWe’ve become preoccupied with health care to the point that we’ve lost sight of who delivers it.  To understand the depth of the crisis look no further than the words of Dr. Jordan Grumet.  This week he announced his pending departure from clinical care.  To think that we have evolved a system so dysfunctional that it can’t support a dedicated doctor of this caliber is unconscionable.

If you have a moment, thumb through his blog.  It’s like a window to his heart.  Be sure to read between the lines.  And as you read, think about what we’re giving up.

We’re about to learn that our healthcare system is only as good as those who deliver the care.


Nancy Hoffman February 8, 2013 at 3:33 pm

I’m a neuropsychologist and I am so tired of being jerked around by the insurance companies that I am also looking for a way (any way!) to get out of clinical care. I think the 3rd party payers have made this work so miserable that it just isn’t worth it at times. I have several cases where I have spent more time trying (unsuccessfully) to get paid than I spent on the entire evaluation process. I’m very tired of it.

Cheryl Handy February 8, 2013 at 9:02 pm

Nice post. I never had the privilege of communicating with Dr. Grumet. That fact notwithstanding, it is sad to lose a dedicated physician to a system.

The post’s final sentence is important. As a former practicing healthcare law attorney, I know words are significant. The move from “patient” to “consumer.” The move from” informed” and “engaged” to “empowered.” Those semantic transitions are disturbing enough.

As a patient advocate especially for the elderly, I am struck most by the move from “physician” to “medical care provider.” There is a profound difference between a physician and a medical care provider. The former is a highly educated professional and the latter could be anyone from a physician to NP to a medical assistant (no disrespect intended). It is all about what “medical care provider” is most cost effective for the particular patient encounter.

The new normal in healthcare requires that patients be prepared to see whatever “medical care provider” is deemed to be most appropriate for the particular encounter. Patients are told they might not be treated by the physician. But when the dust of the patient encounter settles and the physician signs off on charting, it is the physician who assumes complete responsibility.

As I have screamed from soap-boxes, the further the medical profession strays from the direct physician-patient relationship, the more patient care will suffer. I am convinced that, in response, (1) physicians will become overwhelmed by enormous case-loads, paperwork and reliance on paraprofessionals for their patient care; and (2) patients will become frustrated and insist that they must be fully empowered equal partners with physicians. Both responses will be over-reactions. Both responses will further sever the physician-patient relationship.

William R. Taylor, M.D. February 13, 2013 at 9:44 am

Having just reviewed many MD’s despairing posts (see “In Their Own Words” by Phillip Miller, et. al,) I can understand Dr. Grumet’s decision. I’ve also just completed the draft of a book on suicide by health professionals, and am deeply moved by the level of despair or the draining of emotions that they undergo before they take the fatal step. I wish I weren’t turning 80 this year, and could enter the fray to help with the needed reforms.
How do we reach out to those who are desperate and don’t see a way out? There are prevention programs around, but more is needed.

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