Stumbling and Mumbling takes a look at Dalrymple's piece on The Proletarianization of Doctors.
Indeed, the de-professionalization of physicians is happening all over the US, and not just in countries with socialized medicine. I most recently became disturbed by this when I was told that docs in a certain charity clinic that I am familiar with have been asked to punch time clocks when they come on duty.
Of course, it's all about money and power. When physicians become employees with no independent function as professionals, they can begin to lose their identity as professionals. It already happened to public school teachers when they unionized, but docs, being generally made of sterner stuff, do not fold so easily.
Fact is, this charity clinic I refer to (which has family practice/general practice, OG/GYN, dental, and psychiatric staff) is staffed by docs who want to sacrifice some of their time to the poor, but they have been told that if they all were to quit, they would be replaced overnight with docs from India and Pakistan who would not view the job as charity at all, and who have a different view of medicine that the traditional American view.
Money and power. It all began in the US when hospitals began to be run by managers instead of by doctors, in the 1970s. Hospital boards with an eye on the bottom line wanted compliant employees instead of cranky, demanding, patient-devoted docs running things.
We should have seen it coming when insurance companies replaced the line for "physician" with a line for "provider." Provider? I am no provider. As a psychoanalyst and psychiatrist, I am quite the opposite: I am a demander, if anything. A demanding friend, whose time is worth a lot. Not a caretaker or care-giver, most of the time.
And that is why I am willing to be paid to teach, but am not willing to be paid to work by anyone other than my patients. Medicine is a fraternity/sorority, and a guild, and a priesthood with daunting responsibilities which extend far beyond the technicalities of medicine into the realms of friendship, love, the soul and the spirit. If that doesn't matter to people, they will live to regret it.
A few weeks ago I took a stab at the subject of American medical care, and the relationship between patient and physician, "Providers or Physicians?"I recently stumbled upon a better piece on the same subject by Dr. Bob in which he explains that
Tracked: Mar 28, 13:27