How should docs take on overwhelming challenges? Together.
by Michael Lievens, MD
These monthly columns are a unique experience in my career in medicine. On one hand, it is another task to perform. One more job that has to be done.
On the other hand, it is a great opportunity to think about medicine as a whole. To think about the career of medicine, and how it has changed and evolved since I entered medical school in 1985.
I have done more than my share of whining and complaining about many of those changes. I can especially get on a rant about the electronic health record, and how it is taking so much of the joy out of the daily practice of medicine.
However, I always come back to the same thought: I still love it. I still fi nd it a challenge. I still love talking with patients and helping them to feel better, be healthier and, hopefully, live longer.
I still find it an “adrenaline rush” to scope a brisk GI bleeder, or to drain pus from a bile duct. I love the feeling when patients and their family trust and respect me because of the help I have been lucky enough to provide to them.
One of the greatest joys in my practice is seeing chronic liver disease patients – whom I have followed for years as they fought a steady decline in their quality of life – on their fi rst follow-up visit after receiving a liver transplant. It is truly a new life for them that must be witnessed to believe.
I still get excited about the future of medicine, from the patient care side of things. But there are many diffi culties facing medicine as well. Locally, we have a physician shortage. It is a critical shortage in many specialties. The international medical graduates are a tremendous asset in addressing this, but despite their participation, we still have many holes to fi ll.
We have a local medical school, which helps. We have local GME programs, which clearly help. But, alas, these have not been enough.
As many of you are aware, a new osteopathic medical school is planned for downtown Wichita. Lots of work still needs to be done and obstacles overcome before this will bear fruit in providing more doctors for our community.
Many practices have incorporated mid-level providers, which also has helped. But despite all of this, many of us are feeling great pressure to see more patients, and add more on to the day. Waiting lists in some specialties are months long.
I don’t have any easy answers to resolve this shortage. In fact, it is likely to worsen. Baby boomers are turning 65 at a rate of 10,000 people per day in the U.S. Those people need care, and many in our workforce are members of that generation.
Like many problems that face us now, and like so many problems that have been overcome in the past, the answer will require considering ideas and actions outside the usual way of doing things. Doctors, mid-level providers, hospitals and community leaders will need to work together, perhaps with a diff erent paradigm.
The business side of medicine, and the money, is an entirely diff erent subject, which I am not qualifi ed to discuss in any intelligent manner. However, the way the work of patient care is carried out currently is placing great strain on many pieces in the system. We as doctors need to play a big role is fi nding a new paradigm.
The problem with that statement is that we don’t have time. It is the classic riddle of the swamps of the southeast U.S.: How do you get rid of an alligator infestation? Answer: Drain the swamp. But how do you drain the swamp when you are constantly slapping alligators off of your backside?
I strongly believe the answers have the best chance of developing when doctors know one another and communicate with one another. This has grown as a theme in my experience in MSSC leadership. It is what makes the MSSC as important as ever.
If we all stay in our own little worlds, without talking to one another face to face, the answers to our problems will be developed and implemented by others – and the practice of medicine, and the experience of medicine by patients, will suff er as a result.