Doctor, You’re Just a Number
Admit it, you know you’re a number. If you are employed by a large healthcare corporation, chances are your recruiter is one of the few who knows you. I mean, how many people who have an impact on your employment actually have spent time getting to know you? Your trajectory remains either clinical medicine or being “promoted” to administrative positions, where you will begin telling physicians how many patients they need to see and how much they have to improve their HEDIS scores, where you will try to justify pay while whining about how insurance reimbursements have gone down, and where you will begin to learn how to handle patient complaints while you ultimately realize how badly the system is broken, and you are now a part of it. Trust me, I know. I was once a part of it, and while I thought I could change health care top down, I realized I couldn’t. I had to break it before it broke me.
And if you don’t do well, you’re equally dispensable. There’s someone out there, possibly even a non-physician, that threatens to replace your spot especially if they are “cheaper labor” than your cost and may claim they can provide medicine equal to yours, irrespective of your hours of overnights while you were giving up your own sanity trying to save a complicated patient in the ICU, and making hard-pressed decisions every minute.
In the large sea of health care, it’s not like a private practice where each person matters so much more. The machine has to keep moving, the wheels have to keep turning, and the factory must keep producing its product – insurance reimbursement-driven health services, where your client is ultimately who pays you – your employer and your insurance, and the patient is merely the object on whom the product is executed by you. Which is why they feel like a number – they are. But guess what, so are you.
Perhaps the only fields that have some degree of security are those that are procedural. Because in those fields, your style, technique, and methodology is what sets you apart, and usually is far more important than your bedside manner or your patient relationships. Not that you don’t have them or that these don’t matter, but that is not the primary focus of your work. This is different for those of us in primary care, for whom relationship building is the core of our success in addition to our clinical prowess.
So in this large abyss, where we often hear that patients feel like a number, it is a stark reminder that if you are an employed physician in a large operation, you are also just a number – and we know for every primary care physician that is owned by a health care system, that they generate over $2 million in downstream revenue.
So, Doc, how can you not feel like a number? We talk about it from the patient perspective a lot. But we don’t often talk about it in the context of the physician. From the patient perspective, we give them more time, more resources, active, listening, And accessibility. We make them feel heard. And while traditional healthcare tries to do this, it often still misses.
But how does a physician not feel like a number? Is it doing more yoga to battle burnout? Is it getting a side gig so that you find meaning in something else besides what you’ve dedicated your life, your family and your sleep to? Is it going to see a therapist?
I’m not sure I know the answer for everyone, but we have to ask the answers for ourselves. And learn from other physicians who are going through the same thing. I found my answer, and I’m living and breathing it every day. And I share what I’m doing. It’s like we do with our kids – we can’t force people to do something. We just show them how we do it, we model it. And it’s hard… really hard. You are fighting against currents. And just like not all of our children can be reached by our messages, not all doctors are ready to admit that they are a number. But when you are ready, know you have an entire community ready to help you find yourself again.
