By Dr. Howard Brody
Danielle Ofri, a New York general internist and noted physician-author, recently told Time.com how she had been tempted to quit medicine. She described a new patient with multiple medical problems taking 18 different medications, who arrived with two forms that she needed her doctor to fill out, plus numerous photocopies of records from previous physicians.
The patient spoke only Bengali, so Dr. Ofri had to use the hospital’s telephone translator service. Fearful that she’d get behind on her required charting, she tried to document as she went along on the computerized record on her desktop — until the computer started malfunctioning. At 45 minutes into the 15-minute-scheduled visit, she had computer tech support in a phone at one ear and the interpreter talking into the other, with six more patients waiting to be seen.
I mention this doctor because my job is to teach humanities and ethics in medicine. Some describe this as an effort to “humanize” medicine, to remind our students that medicine is about people and not just about memorizing a lot of scientific facts.
Well, I have news. If our health system treats physicians like dirt and grinds them into the ground, you can sprinkle all the humanities courses you want on top and it won’t “humanize” anything.
The people who manage these health systems seem to have decided something a while back. They decided that you could put doctors inside wire wheels like gerbils and tell them to run faster and faster. They decided that you could keep piling on extra paperwork and red tape, that have nothing really to do with taking good care of patients, and doctors would just suck it up.
Saying this sounds mean toward the managers, so let me correct this. I don’t actually think that anyone made this decision. I think it all just happened without anyone planning it. But we still ended up in the same place.
Suppose, instead, that we had seen all this coming and asked from the get-go how to create efficient teams of health workers, with each team members doing what they were especially trained for, whether taking care of patients, filling out forms, or clicking on computer screens. And suppose we did a better job of training everyone in health care how to be better team players.
Some people would object that the doctors deserve no sympathy. Look at all the money doctors make. It’s about time they had to run around in gerbil wheels to justify their income.
Now leaving aside whether a frantic, hassled person running around in a gerbil wheel is the person you want responsible for the care of someone you love who’s very sick, I’ll make you a bet.
I bet that if doctors had a choice — less hassle that has nothing really to do with patient care, in exchange for making less money — most would jump at the chance to de-hassle their practices.
Most physicians chose a medical career because they truly value establishing positive relationships with patients and figuring out how to make patients better. I propose that we let them.
Dr. Howard Brody is director of the Institute for the Medical Humanities at the University of Texas Medical Branch.