The US Healthcare System is in Crisis
The US Healthcare System is in Crisis. Doctors are dying and patients are getting sicker, while the corporate healthcare system continues prioritizing profits over quality patient care.
The New York Times article, “The Moral Crisis of America’s Doctors” (https://www.nytimes.com/2023/06/15/magazine/doctors-moral-crises.html), nails the toxic effects of the corporatization of American Healthcare.
The article’s author, Mr. Eyal Press, powerfully portrays the dominance of for-profit, corporate healthcare in the USA. He particularly focuses on the implications of stripping MDs of medical decision-making and placing it into the hands of now dominant non-medical, profit driven corporations, run by MBAs and CEOs.
As former Chief Medical Officer of McLean Hospital, a Harvard teaching hospital, I was a first-hand witness and first-responder in saving this storied hospital from closure or sale as the result of the collision between traditional medicine and corporate healthcare.
The highest burnout jobs are all in the field of healthcare.
Doctors go to medical school full of ambition to become the best doctors they can be, and to help people to overcome illness and live life to the fullest. As medical students, especially in the 3rd and 4th years, they learn the truth about the American healthcare system. They leave med school and residency beaten down and indoctrinated.
From the first day of being a medical student to the first day of entering residency as a junior doctor, the system is designed to dehumanize and desensitize to human suffering. “I hate being a doctor” is a phrase I have heard spoken all too many times in private conversations with many physicians working in private practice, academic medicine, or in corporate healthcare jobs.
Healthcare organizations, focused on profits above all else, push clinicians to the point of burnout, and even suicide. From mental health workers to surgeons, doctors are literally dying from job-related stress. The medical field is at a breaking point.
We are far past the days when a family could depend on being with the same family doctor for many years. Now, your primary care physician is chosen for you by your insurance company. Clinical practice is more about paperwork than seeing patients.
Why do doctors hate their job and patients hate going to the doctor?
What happened to the medical profession, where sick people cannot get more than a few minutes with a medical doctor to get help with their problems? From the exam room to the operating room, the healthcare professional is always rushing from one patient to the next, because that is what the system requires of them to keep their jobs and feed their families.
The public has begun to place their hopes of better healthcare in the hands of wellness centers and psychedelic drug clinics. Why can't we fix our broken healthcare system first, instead of relying on the empty promises and snake oil offered by many alternative medicine practitioners?
We as patients and families, in addition to doctors and hospitals, are falling prey to the consequences of for-profit medicine.
To name a few:
terrible problems accessing a primary care doctor and appointment wait times of months;
“drive-by” 8-10 minute doctor (or nurse) visits;
Americans (in most states) are expected to live shorter lives than people in all other developed countries (https://www.commonwealthfund.org/blog/2022/americans-no-matter-state-they-live-die-younger-people-many-other-countries);
yet the US has the highest costs of healthcare than any other country on the planet (https://www.commonwealthfund.org/publications/issue-briefs/2023/jan/us-health-care-global-perspective-2022#:~:text=In%202021%2C%20the%20U.S.%20spent,higher%20than%20in%20South%20Korea.);
with costs increasingly being unloaded onto you and me; (https://www.nytimes.com/2023/06/15/magazine/doctors-moral-crises.html);
growing workforce shortages as doctors and nurses flee medicine as profits trump patients;
medical record-keeping by doctors can take twice as much time as patient care;
a pervasive de-humanization of medical care, where dollars, not patients, rule what treatment we receive and how we are cared for;
and so on…
We now live in era when ‘make a profit at any cost’ (but not to the insurer or corporate intermediary) gives no quarter to caring for the patient, the hallmark of good and ethical medicine.
Must we as patients, families, doctors, and hospitals accept the indifference and disregard we are subject to by for-profit medicine? No. But the fight can’t be done alone or overnight.
“Lloyd’s Sederer’s brilliant new book about the revival of McLean Hospital from a near death experience, teaches us how to “rethink the status quo” of any institution or organization. From “toxic treatment” to “do no harm” from “report cards” to creating an “institutional moral compass”. His new book, Caught In The Crosshairs Of American Healthcare, shows us step by step how to challenge established protocols and prove their efficacy. By doing so Sederer shows us how we can save, reshape and rethink the destiny and relevancy of our institutions, bureaucracies and communities.”
Francis Greenburger, CEO, Time Equities; CEO of the Greenburger Literary Agency; President, Greenburger Center for Social and Criminal Justice
Lloyd I Sederer, MD
Adjunct Professor, Columbia/Mailman School of Public Health