About a year ago, I wrote about how physicians are being devalued. More recently, I posted on my Facebook page how, in the current time of need, physicians are suddenly being valued more. I noted how in the midst of the COVID-19 pandemic, the powers that be are turning to the same physicians to lead us out of the crisis. I alluded to compromises being contemplated with regard to issues such as surprise billing and prior auth. I noted that reporting requirements for Medicare quality measures have been relaxed. Even ABIM has postponed its spring exam. But I was wrong. There are numerous examples today of how even in times of crisis, physicians (and in many cases, other critical health care workers) are devalued. Let me share a few. In Washington, an emergency physician was fired for publicly protesting the lack of protective measures for hospital workers during the COVID-19 crisis. The shortage of PPE has resulted in health care workers not being adequately protected. They may be forced to reuse materials, risking their own safety. In some cases, nurses report using trash bags as PPE, which would be laughable if it were not so serious. There are reports of administrators advising doctors and nurses not to wear PPE because it might frighten patients. Does the hospital image supersede safety for health care workers? The Department of Licensing and Regulatory Affairs in Michigan has threatened physicians who write scripts for hydroxychloroquine for patients with COVID-19. Admittedly, there is great controversy as to whether the treatment of COVID-19 patients with hydroxychloroquine is appropriate or not, but why are bureaucrats deciding this, and why are physicians being threatened with disciplinary action? Shouldn’t patient care decisions be made by individual physicians tending to individual patients? Is there so little trust in physicians’ integrity to care for patients to the best of our ability? In Pennsylvania, lawyers are pushing for malpractice cases to go forward without delay. Attorneys are likely taking a financial beating, but so is everyone else, including physicians. To ask physicians to focus their attention on legal issues in times of such a crisis is unconscionable. Why can’t there be a moratorium so that plaintiffs can still have their day in court, just not right now while physicians struggle to treat patients during a pandemic? The final kicker is that as I write this, it is Doctor’s Day. First of all, Doctor’s Day has been extended to National Physician’s Week on the national calendar due to work done by the grassroots group Physicians Working Together. However, many institutions still only recognize Doctor’s Day. Even at that, some hospitals extend thanks to “doctors and other clinicians.” One physician noted that her hospital thanked its doctors and APPs, lumping them together. It should be noted that there are separate weeks for nurses in May and for nurse practitioners in November. I have nothing against nurses, NPs, and all of the other health care providers who are risking their own safety to take care of patients. All are true heroes and are to be commended and applauded for their sacrifices and their bravery. I recognize that I may come across as petty, given that there are much more important issues at stake. Nonetheless, physicians are human. Just like anyone else, we do not want to be taken for granted. It would be nice if administrators, legislators, and hospital CEOs showed appreciation for what we do as physicians with their actions as well as their words. I have a strong feeling as to what will happen once the crisis is over. I suspect it will be back to business as usual. Any current loosening of restrictions will tighten up again. Regulations that hinder our ability to care for patients will be put back in place. While physicians will receive thanks for what has been done during the COVID-19 pandemic, I just cannot see meaningful changes in prior authorizations or regulatory demands, and once again, administrators will demonstrate just what they think of physicians. Here is hoping that I am way off base in my thoughts. Maybe this experience will change the way physicians are viewed. For as much as I am talking about physicians here, that which affects physicians also affects patients, and patients should always be our number one concern. Mark Lopatin is a rheumatologist. Source
