Do the Right Thing, Always
My brother is the CEO of a tech company, and when he was being interviewed for a podcast, he said that the main principle he lives by is “Do the right thing, always.” This is a principle both of my parents embodied and passed along to us. This principle is expected in medicine, which is why we are horrified by physicians who do not embody it. However, there is now a general lack of honesty and integrity in the business and practice of healthcare since corporations took over and pushed physicians out of leadership roles. Physicians are considered “bad at business” because we tend to make decisions based on ethics rather than on profitability. This is why we are being systematically replaced by those who are more malleable, and thus more profitable.
The business of healthcare is focused on generating and filing insurance claims, and patients are to the healthcare industry as cattle are to the meat-packing industry, pushed through as quickly and efficiently as possible with no regard for their humanity. Doctors, nurses, and other medical practitioners remained committed to compassionate patient care, but as mere employees of this system, and with ever-increasing patient loads, they are unable to dismantle the assembly line. In fact, they are also victims of the healthcare system, battling burnout and moral injury.
Meanwhile, there is a general sense of apathy among those working in the administrative healthcare positions at every level. I can empathize with their frustration as they helplessly field patient complaints over insurance denials, high costs, and long waits; however, it is disheartening that they have absorbed the anti-physician rhetoric from the corporate administrators at the top. Ultimately, the blame is placed on physicians: your doctor never sent it, your doctor coded it wrong, your doctor is to blame, not us!
At least once a week, a patient will reach out telling me that a pharmacy did not receive the prescription refill that I sent in or that a specialist did not receive the referral I faxed. Patients are shocked to learn that these pharmacy techs and receptionists are simply lying to them in order to decrease their workload. In the same way that a fast-food employee will claim that “the ice cream machine is broken” because they don’t feel like cleaning it again, dishonesty in healthcare has become commonplace.
Recently, one of my patients was turned away from an imaging center for her scheduled CT scan because they claimed that I never faxed them an order. The patient was dumbfounded because they clearly had my order when they called her to schedule the imaging. My most savvy patients will call their bluffs and show them my text confirmations, and then the missing prescriptions and orders will magically appear!
In Direct Primary Care, we are returning honesty, integrity and humanity to the practice of medicine by working directly for our patients and separating ourselves from the unethical practices of the insurance industry. Although our patients still must navigate the healthcare industry, they can breathe a little easier knowing that their DPC doctor has their back and will make sure that they get the appropriate care. They can trust that we will continue to do the right thing, always.
