Friday, July 18, 2008

Don't blame docs for problems with U.S. healthcare

This week, I've been involved in a debate in my business ethics class about healthcare that I wanted to share because I think it reflects many common misconceptions and illustrates the impact the media can have on people's perception of reality.

Using the Kings County Hospital death as an example, my classmate argued that many physicians have compromised ethical behavior for the pursuit of money. She contended that they have lost their allegiance to the Hippocratic Oath (which she spelled Hypocratic; ha!). As I shared with her and the class, I think it's dangerous to make broad generalizations about whether certain groups or categories of people behave ethically or not. Decisions about both personal and professional ethical behavior may be influenced by environmental factors, such as the culture of the organization within which one works, but these decisions are ultimately up to the individual.

My classmate wrote, "They [physicians] certainly take no thought of how partnering with pharmaceutical companies and providers of healthcare insurance can and sometimes do adversely affect the care they are able to provide to the have-nots." [!!! ] With a husband, sister-in-law, and best friend who all work in healthcare and regularly share their experiences, I've learned that the relationships between physicians and pharmaceutical reps can actually produce positive outcomes such as increasing doctors' knowledge about new treatment options. And as far as health insurance is concerned, many doctors are just as frustrated with insurance companies as patients are, but they choose to maintain those relationships so that they can provide more patients with access to care (most people rely on insurance-- whether government- or employer-provided-- and can't afford to see a doctor on a cash-only basis). My instructor shared that his child's pediatrician left private practice and became certified as a middle school teacher because, though she was an excellent doctor, she had to fight each insurance claim and couldn't seem to get ahead. "She was in medicine to help kids," he said, "and decided teaching was a better way."

Another classmate expressed that doctors seem to donate time in other countries but not here in the U.S. That is another huge misconception. My husband has observed that every doctor with whom he has completed a clinical rotation (all of whom have different specialties) has quietly provided free medical services to certain patients who can't afford them because they know these individuals wouldn't seek needed care otherwise. My husband and I also know many physicians who donate their time at free local clinics. The overseas services provided by physicians are just more publicized, which is why we're more aware of them. Personally, I have more admiration for those who quietly care for the less fortunate, without any recognition or glory for doing so. That's humility.

My point: The vast majority of physicians haven't dedicated roughly a decade of their lives to completing a medical education and residency (and in many cases gone into signficant student loan debt) just because they're out to make money. While it's true that we can find examples of unethical behavior in healthcare (such as the highly publicized NY hospital situation), I could point out just as many examples in almost every other industry, too, from banking (e.g. predatory lending) to retail (e.g. sweat shops). Shame on the media for only reporting on negative events and keeping people in the dark about the good that physicians are doing for their patients and communities.

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