It seems that many physicians finally realize that they are expendable. The fact that U.S. health care institutions view doctors (and every other employee) as disposable cogs in a machine is not a new phenomenon. I learned this lesson over a year ago as a vulnerable type of provider – a resident physician. From someone who has already been disillusioned, let me assure you, you won’t forget how you were treated during this time of crisis. When you needed help the most, the people who could have and should have supported you failed. They took masks from your faces, they made you use vacation time to quarantine, and then they fired you for speaking up. The machine of health care is cold and calculating; it has no room for petty human concerns like personal safety or ethics. In my case, it wasn’t a pandemic that shone a light on the sinister machinations of the for-profit health care system. Only the tiny tragedy of a physician behaving badly and escaping negative consequences. As a newly minted doctor and an employee of this physician, I knew I was ethically obligated to report my boss’s bad behavior to the supervising authorities. I didn’t know what might happen after. When I began my residency training at a large, academic medical institution affiliated with my former employer, I learned department leadership had known for years about this doctor’s unprofessional, dangerous, and sometimes illegal behavior. They decided long ago that it was worth allowing the abuse of patients to continue for the sake of appearances and income. These “leaders” response to my complaint was to threaten, harass, and silence me. Because I was a smaller cog in the machine, generating less value for the institution than the person I reported, my program director sighed in relief when I resigned. They didn’t need me. No doctor who has heard my story has been surprised by the outcome. Disappointed, maybe, but not surprised by the callousness of a powerful institution squashing a young professional career. There is no outrage and little sympathy when they hear I left to preserve my own mental health while being ground down by the pressures of residency, workplace harassment, and an unjust, inefficient system. Does any of this remind you of how you’ve been treated lately? I beg of you, let the memories of anger, fear, and despair fuel you, long after the end of this epidemiologic curve – because it’s the same emotion felt by patients who battle an overwhelming, impossibly complicated system to be seen as people who need help. It’s the frustration felt by every doctor who talks about retiring early or fleeing a sinking ship. This is the system that is eating us alive – med students, doctors, nurses – none of us should feel so trapped by this machine that we have made that we have to stop doing the jobs we love or stop living. And we did make the health care machine – as humans. Anything that humans have put together, we can take apart and remake. Although the public may have sympathy for us, especially at this moment, they will not fight for systemic improvements. No government is coming to save you. The administrators have never cared about us as people and never will. When was the last time the American Medical Association (AMA) or any other dues-supported group helped you – do you trust them with the future of medicine, based on what they’ve done so far? It is up to you doctor (nurse, PA, etc.) to build an entirely new way of leading and delivering medicine. Let’s start by fighting for PPE and not stop until we have torn apart American for-profit medicine and built a health care system that we can be proud of. After all, who better to do it than those who live in the labyrinth of hospitals and touch patients every day? Who else could be trusted? Take some comfort in knowing that we are all losing bits of our humanity through persistent suffering and sacrifice, laid at the altar of profit. Remember that it doesn’t have to be this way. We can choose to put patients first, workers second, and giant institutions in a distant third. We could even build a future where people can publish pieces like this one with their names attached and still have a career. After all, we are some of the best-educated, most ambitious people on the planet. Let’s work to prevent the next tragedy of health care, be it great or small. The author is an anonymous physician. Source
