Are we losing Trust in our Healthcare System?

My father-in-law enjoyed great success as a leading Cardiologist in private practice for over 30 years. He retired a little over eight years ago because of his age, but most importantly, because he was losing his trust in where the healthcare system was going. Over the years, we have had many discussions about how doctors practiced in the U.S. and how much freedom he enjoyed treating his patients without the interference of big insurance companies and hospital systems. He would talk about the good old days when patients listened to their doctors rather than fact checking them against Google, and doctors being able to spend ample time with their patients by getting to know them and having the privilege to treat multiple generations of the same family. There was trust, faith and respect physicians enjoyed from their patients and colleagues.

During several conversations, he mentions that his colleagues who are now retired but accessing the healthcare system as patients are finding it difficult to create that bond with their "providers". It seems that a majority of new physicians are looking for job security in terms of a nice paycheck, paid time off and other perks offered by big hospital systems or private equity firms rather than going into private practice and enjoying their autonomy. I told him that it is because of the diminishing reimbursement from insurance companies that physicians choose the safety and security of a job to minimize risk. After all, physicians have a mountain of debt from years of schooling, and a steady paycheck is a security blanket while they work to become debt free.

Another aspect that troubles him is that patients are being forced to change their preferred doctor based on the insurance plan they choose. Now, I have been pretty loud about how Medicare Advantage Plans deceive our vulnerable senior citizens into believing that it is a better choice over Traditional Medicare. This may be true in some instances, but looking from the other side, it creates a boat load of work for the physicians. The paperwork required to request prior authorizations for procedures and life-saving medications is getting ridiculous by the day! At the grassroots level, patients don't have an understanding of the intricacies of how insurance works. All they can see is that their doctors are becoming machines, glued to their computer screens rather than looking and touching them to diagnose the problem.

When I argue that it is the physicians who have let this happen over the last couple of decades, he says that physicians are helpless because they get bullied by the hospital systems. While I don't disagree with him completely, I also believe that physicians gave up their power in order to acquire those shiny things and to fit in with the Jones's and the hospital systems used that to their advantage.

So, how do we bring the trust back to our healthcare system? There is no simple answer to this question, but I do know that there is power in a collective voice. We witnessed that recently, when a plethora of medical societies came together and wrote letters to Cigna to push back on their policy to request medical records for office Evaluation & Management Codes billed with a modifier 25 with minor procedure. There is definitely a lack of unity among the physician community because according to my father-in-law, doctors don't have that power to stand up to big hospitals, big pharma and big government. But I think that doctors do have the power. Doctors are the original healers and they have had the faith and trust of their patients for generations. All they have to do is unite for or against something and raise their voices as loud as they can. Sure, change will not happen overnight. It may take a decade or maybe two, but the situation we are in right now also didn't happen overnight. A series of events had to happen to get us to where we are today. So let's unite and raise our voices today. Take action today. Fight the system today because if not today, then when?

I will end with a quote that is apt here, "A Year from now, you'll wish you had started today."