Medicine Over Healthcare: Ten Initiatives to Heal Medicine

I realise that a lot of doctors think that what I write is airy-fairy. Believe me, I’ve heard it all over the last 10 years and for at least 20 years before that. My colleagues can be condescending and dismissive, and mostly I recognise that sometimes as insecurity and often as sheer frustration. Many agree with my analysis but have trouble wrapping their minds around change. But here’s the thing: beliefs are powerful. If we believe we’re stuck, we’re stuck. That’s it.

It became critical for me to get unstuck when I came to a particular crossroad a decade ago. My first question was and still is, “How can a group of people with as much drive, intelligence, good will, and resource as doctors have feel so powerless in a system organised around our expertise?” God knows it's "only" the Kosinski Manifesto, but I invite everyone to make their own. You can use mine as a starting place.

1. The difference in income between the lowest paid and the highest paid person in medicine should be no more than 10x.

2. Forgive all medical school debt and establish debt-free medical education.

3. Make residency a sustainable lifestyle.

4. Establish the Functional Medicine model as the foundation for clinical instruction.

5. Every doctor should write and continually update a Personal Practice Prescription at every stage of clinical training and practice.

6. Reframe and restore physician professional accountability.

7. Continual rebalancing of the 3 priorities of medicine: intellectual engagement, prosperity, and meaningful work.

8. The practice of medicine should not make doctors sick or sick at heart; we should thrive because of our practices, not despite them.

9. Establish a single payer system that covers everyone and includes wellness activities.

10. Know your doctor origin story.

Why these 10 things? What do they mean? Read more at Close to the Bone with Lauren Kosinski, MD

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