I have never been a helicopter mom. I don’t think my children are perfect (though they come pretty close). When they fought with friends, I didn’t assume that they were automatically innocent victims. My children learned how to cook, do the laundry and clean up after themselves at a young age. I have never called a teacher to protest a grade, nor have I written school papers for my kids. I have certainly never shown up at a job interview with one of them, at least past the age of ten.
But there’s a time when enough is enough and this mama bear is ready to go on the warpath. You see, to the utter amazement of my husband and myself, two of our children are in the medical field. Our son is an emergency room physician and our daughter, after a number of years of nursing on a general ward and in the Intensive Care Unit, is now on her way to becoming a nurse anesthetist.
This has given us a bit of an inside view into the medical profession. We have watched our children and their peers work 12 hour shifts and more. We have seen them heartbroken by patients’ deaths. We have sensed their frustration at giving their all to save a patient who they know will be back in the hospital soon after release because she won’t change her self-destructive behavior. We have watched in awe as these doctors and nurses pushed themselves beyond human limits to help those in need. We cheered as they got jobs with good salaries that let them start paying back the exorbitant amount of debt they accumulated while training.
As a consumer, I’m certainly aware that pencil-pushers, bureaucrats and politicians have taken over the medical field. My husband and my premiums have soared as our coverage has dropped. But to someone who, like all of us, will need medical help for myself or for those I love at some point, bureaucratic behavior that discourages and disheartens doctors and nurses is incredibly stupid.
What is going on? Serendipitously, as I was planning this Musing, I read an essay by Cal Thomas entitled, The Doctor is (Not) In. I encourage you to read it as well, but I want to add my perspective.
I am furious at watching my children and their peers be demoralized, demeaned and devalued.
Here’s one example: In many locations, doctors and nurses are no longer referred to as doctors and nurses. They are now called medical providers. That catchall term is also applied to anyone providing any service to the patient. For all I know, if you take a taxi to the hospital, the driver too is your provider. Now, being a taxi driver, an ultrasound technician, a nutritionist or any one of hundreds of different occupations is perfectly honorable and praiseworthy. But you may have noticed that the star of a movie gets different billing than the costume designer, grip or camera operator, important as they are. The byline on the lead article in your morning paper has a writer’s name; it doesn’t say, “one of the journalism team”. Doctors and nurses are not just part of the team, though they are that as well. They, (and doctors rank above nurses in this) have spent more time, money and life blood to do what they are doing. Their responsibility and stress level is higher. They deserve their titles as well as their higher salaries.
Speaking of those salaries, one of the stupidest ideas is setting the pay and/or bonuses of doctors and nurses on the basis of patients rating the treatment they received. Whenever a professional’s performance is rated by members of the public, surely some in depth analysis is needed. Here are some anecdotes I’ve heard now that I frequently find myself surrounded by physicians and nurses.
There’s the nurse who had a patient apologize to her, saying that though she has been a great nurse, the patient is going to rank her low because, “The squeaky wheel gets the grease.”
There’s the doctor who wouldn’t prescribe antibiotics because it wasn’t called for in her medical opinion, who not only got ranked low by a patient who was sure he needed antibiotics, but the patient, in his pique, also added an incendiary allegation to his evaluation, throwing an accusation of racism into the mix.
Or how about the patient’s family who hovered around her bed, camera phone at the ready, getting in the nurse’s way and baiting her, hoping that they could find a way to sue the hospital because it had a history of settling cases rather than fighting them?
And what of the doctor attacked by an awakening drug addict, supposedly protected by a security guard on duty for that reason, except that the security guard is not allowed to touch patients? It’s kind of hard to stop a punch without touching the person throwing the punch.
I could go on and on. These medical professionals then sometimes have their pay docked or miss out on bonuses when these (word deleted because when it came to it, I couldn’t use it) give them bad reports.
I get that there are bad doctors and bad nurses. Sometimes patients are mistreated and even abused. How about a system that finds the bad eggs and punishes them severely rather than a system that infantilizes all doctors and nurses while tying their hands behind their backs so they cannot give the best medical care? Or maybe we should have two sets of hospitals and doctors’ offices. One for decent, moral patients and one for those without principles who are taking advantage of fellow citizens and medical professionals alike.
So, if on your way to the hospital next time, you are stopped by a helicopter mom wanting to make sure that you actually need care and will be a respectful patient, it just might be me.
I’m not sure I should even be writing, but this discussion draws me to tell my story. Twenty some years ago my wife couldn’t shake her cough, so being a weekend I took her to the local ER, and before it was all over she was shown a black spot on her lung about the size of a quarter that they told her was cancer. Having smoked for 20 some years, this really didn’t surprise her. She was told that even though her lungs were severely damaged from the smoking that she could be cured and back on the road in fine shape. She went through 6 weeks of radiation and sure ’nuff – she was back on the road in no time, feeling good. This is a good place to stop, but the story doesn’t end there. About 2 years later she started having these pains here and there and was spending a lot more time with her doctors. Then it got to about once a week by 2 o’clock in the morning I was having to take her to the emergency room. The last time I did this, we switched hospitals on a nurse friends’ recommendation, and I took her further out to a hospital whose ER room wasn’t nearly so busy. Finally she was diagnosed with multiple myeloma, a cancer of the bone morrow. She was bed-ridden for the last 7 months of her life and was on high doses of pain medication. I didn’t think a whole lot about it, taking life as it comes, then my square dance caller’s wife was diagnosed with multiple myeloma. By this time I had joined a barber shop chorus and two more of my friends wives’ came down with multiple myeloma. To throw another item into the mix, my brother-in-law came down and died with multiple myeloma. Now, nobody knows why people get multiple myeloma. It’s been happening for years and we are completely clueless, but in the case of each of these women, all of them had been treated for 6 weeks with radiation.
Did I learn anything from this? 10 or 12 years later I started complaining about vague pains coming and going. Eventually, after a lot of prodding and poking I was diagnosed with prostate cancer. The doctors assured me that after they got through, life would be good again and I could expect to live another 10 or 15 years. My reply was “Thanks, but no thanks. I don’t want to die like my late wife. I’ll take care of it my way. Holistic medicine is all over the internet, so I started studying and caring for myself. I haven’t had pain in my groin for years, and it’s been at least 3 years, perhaps more since I had a cold or headache – those items that just seem to be part of life.
Thank you for listening.
Stephen, your story is valuable and will resonate even though I don’t think it is exactly on the topic of the Musing.
Mrs Lapin, your words echoed those I hear from my ER doctor on a regular basis. And an article I read recently blamed the opiate crisis on this system of ‘patient satisfaction scores’ tied to salary: a pain-free patient is a happy patient. And for the last decade the ER had daily “Frequent flyers” who come in with false complaints just so they can find someone to order them pain medicine. But this doctor’s
latest frustration? Increasing numbers of Foul-mouthed patients and/or family cursing at him and the Nurses, and they “have to just swallow it because if we raise our voice or tell them off , the hospital administration [punishes] us”. He can save someone’s life in one room, and have a belligerent patient down the hall who doesn’t want to wait his turn. My ER RN who works at a for-profit urgent care, however, CAN tell a belligerent patient or their family member (unfortunately this is apparently something that happens regularly) to behave or leave without treatment.
I didn’t realize that urgent care centers have more leeway. Yes, there is a big complaint of people coming in who are in no way emergencies and getting upset when others (emergencies) are treated first. Also, addicts steal expensive equipment. The system only works when the people are good, to paraphrase John Adams.
I too relate with saddened heart work in the ‘Health SCARE’ profession. All too often appeasement has set in not healing. And Realistically, have you thanked Congress for this. The misguided notion we can vote them out…..the damage is already done.
I work in a hospital. There are challenges for sure and regulations that shape medical care in both positive and negative ways. However, like many professions, I know an orthopedic surgeon that makes good decisions, says no to administration, makes a good wage and sets healthy boundaries. He loves his wife and children and makes time to go to synagogue, recite prayers, and practice his faith. He is respected in the community and actively involved in the local school and sports teams. As much as possible, he decides the way he will be a doctor and pushes back against things rather than just accepting that that is the way things are. I admire his take no s**t approach, yet remaining respectful and calm. I guess I’m just saying that we have some power to create the way we want things in medicine and I see someone that rejects a lot of what the system tries to put on him. That takes courage.
I work in a hospital. There are challenges for sure and regulations that shape medical care in both positive and negative ways. However, like many professions, I know an orthopedic surgeon that makes good decisions, says no to administration, makes a good wage and sets healthy boundaries. He loves his wife and children and makes time to go to synagogue, recite prayers, and practice his faith. He is respected in the community and actively involved in the local school and sports teams. As much as possible, he decides the way he will be a doctor and pushes back against things rather than just accepting that that is the way things are. I admire his take no s**t approach, yet remaining respectful and calm. I guess I’m just saying that we have some power to create the way we want things in medicine and I see someone that rejects a lot of what the system tries to put on him. That takes courage.
Thank you Susan Lapin for this article which gives us a detailed analysis on how the doctors and nurses are perceived today. The doctors and nurses are very important aspect when our life is in danger. When you become sick you real need to be cared by your friends, relatives and doctors/nurses too. I have a good experience of working with doctors and nurses in serving patients. Through that experience I have learned that always patients need to be cared, respected and to be valued. Therefore, I think we as human being we should avoid making a general conclusion that doctors and nurses are bad people. What I know is that doctors are nurses as human being sometimes are being highly frustrated with the existing system or working environment. As a result patients may be affected. The article has been highlighted some challenges facing doctors and nurses. Yes I do agree with those critical challenges, but I think the main problem is poor management system. Louis who is one of the victim has tried to highlight some of the challenges experienced or faced with doctors while accessing health care services. He spend a lot of time being asked the same questions every time when is attended by the doctors. This shows that there is a serious problem with the system. If I am attending a client or patient whose a problem is known I think it could be wise to listen him or her if there is any improvement or dis-improvement. Based on my experience I think patient with a chronicle disease should be attended with the same doctors and nurses to avoid asking same questions now and then and if there is any changes of the doctor or nurse you need to read the history before attending him or her.
Let me share with you of what happened to me too. Recently, I have sent my son to one of the big and known hospital. It was a bad day to me . I spent 7 hours in hospital waiting for treating service. I was observing what is was going on there? There was long queue for patient waiting to see the doctor. There was no system there and no control. Remember some of the patients were more serious and some of them waiting for medication. Actually I realized that one of the problem was no procedures for patients in entering to the doctor room. As a result every patients wanted to be attended first. Finally, the two patients forced to see him. The doctor was highly frustrated and then decided to leave patients unattended. I decided to complain to one of the junior nurse as to why the have a poor system for attending patients? She told me that late me go and report to the management. Actually, learned that there was no clear management system and no one was overseeing it. Therefore, poor management system in hospitals is one of the critical challenges affecting doctors, nurses and patients.
Spot on! If only those not in the medical field understood what has been and is going on. Few doctors are independent anymore because their income is set by the government and insurance companies while overhead including employees salaries have gone way up. Most docs join groups now because that is affordable, but they become employees and are then told what to do. Independence has created good medicine. Today we are headed for socialized medicine. I could go on and on. I live with a doctor. He has been called every horrible name you can think of. Called swear words we think are not said in public and spit on. Screamed at when he doesn’t do what a patient wants and decides the doctor’s diagnosis is wrong. It is the part of medicine that most people never see.
Karen, thank you for being in your husband’s corner.
There is an article I wish everyone could read, titled “What Does Knee Surgery Really Cost? Few know, and that’s a problem for health spending.” It is in the Wednesday, August 22 issue of the Wall Street Journal. Basically, they pick a number out of the air then add 3% annually. Rarely does anyone examine the personnel, equipment, supplies and so forth to determine actual cost to the hospital before setting a list price. The featured hospital was charging more than $50,000 for a knee replacement in 2016. After an 18-month review they found the actual cost was $7,300 to $10,550 including physicians. (They made changes)
I tend to agree with Mr Eisenhauer, we don’t need more socialized medicine run by bureaucrats.
Lyna, I read the article and, yes, everyone should read it. Everyone should also have direct consequences and choices by knowing what things actually cost.
Susan, I love reading your Musings as you are so articulate and I don’t find that very often. Though I read your words, I know there is more that you are holding back and your personal investment in the medical field (as a consumer and a mother of a doctor and nurse) holds your tongue. In your opinion, what are some low-hanging-fruit in the current medical system that could be fixed fairly easy (in a perfect world)? I am very interested in your insight and I’m doubly interested in how I can pray for easier solutions in my community and perhaps take action in ways I don’t currently know exist.
Thank you, Renae. Here’s my first suggestion: Congress should have to live under whatever laws it passes for others. They should not have a medical system that is different from the one we have. Nor should they get pay raises or other perks in underhanded ways.
Gee, maybe the voters should be allowed to rate their representatives, and any pay raises will be based on those ratings. And yes, congressmen and women should be required to pay into and use the Medicare system for their health care; many physicians in my area don’t accept Medicare patients due to the mounds of paperwork and low reimbursements, so those of us nearing retirement age often have to look for a new primary care physician after years of working with the same person.
Governments fingers in any pot is never a good thing. Wish more people understood that.
I don’t know if I agree, Lynn. Government does have a function, but the tendency is to grow and grow to the point of being unhelpful. How to keep on pulling back while recognizing what government does best is a quandary societies have grappled with since there was society.
Well said Mrs. Lapin. I would like to give you another thing to think about. Socialized Medicine.
I’m a retired soldier that is 100 percent disabled. I suffered a massive stroke shortly after retiring, my back is mangled after years of abuse as an Infantryman. I have a good amount of other issues as well. Do not fret, my life is as it should be, I’m in the care of The Master of the Universe and couldn’t be happier.
Every trip to the Veteran’s Affairs Hospital (VA) to see my primary care doctor or nurse practioner starts out with a list of mandatory questions compiled by those “on high”. It usually is the soup du juor of media highlighted problems…”do you have guns in your house, how much alcohol do you drink, are you afraid of being homeless, do you think of killing yourself or harming others?”. These are asked of each and every patient along with a checklist of things the doctor must do and annotate in the patient’s computerized record or they take a hit. It is what we all know as CYB work…Cover Your Butt. By the time this process is over they do not have time to really know their patient because two more are in the waiting room and they must only be seen for the prescribed amount of time.
Whenever a doctor moves or retires you are never given any notice until after the fact, this has happened 5 times in the last 10 years. My newest doctor started out our relationship by telling me that I took too many painkillers and that I must stop. She didn’t even look at my history. I had to stop her and give her a little wake up call and not accuse me of being a drug addict. She actually said that.
To make my point now. I could make a list that would make you sick, so I won’t. These doctors and nurses are forced to wear horse blinders and follow a checklist. Sometimes people are forced into being the squeaky wheel.
I am fortunate in that I am not afraid to advocate for myself and not take no for an answer. I read and research, ask questions and to not accept illogical or pat answers.
The VA has saved my life and sometimes I swear they have tried to end it. In my humble opinion many of their problems are a direct result of being socialized medicine. The answers come from the Hydra Monster also known as the US Government instead of a real relationship between doctor and patient.
Thanks, now my blood pressure is up.
You guys are the best.
Well, I certainly didn’t want to make your blood pressure go up. Everything you said, however, is sad but true. It’s not only the VA. One of our daughters had to leave the pediatrician she trusted and liked because of Obamacare. The new doctor (who she only went to once) spent the first visit there looking only at the computer screen. He never even looked at the whole child – only at parts of him at a time.
Wish we lived closer, would be an HONOR to serve you……
Thank you Carl–
hope to see you when we get to the Carolinas
Cordially
RDL
I’m a family doctor! 🙏🏻 Thank you! Thank you! Thank you!
ABsolutely agree.
Dear Susan,
Fortunately, I’ve not had to deal with doctors and hospitals very much, but as I’m now in that “glorious” senior citizen category, I do have more doctor’s appointments these days. Never in my wildest imagination could I see myself conniving to downgrade a doctor or nurse.
A number of years ago, with a pain in my side, I ended up having an emergency appendectomy (they told me in another 24 hours I would have been dead).
These people are life savers—literally!
I’ve always wondered about the diluted terminology that’s used more and more these days, and I can only agree with you: doctors and nurses ARE special. Everyone else who needs to see you are fine people, but they’re not nurses and doctors. And if their tiny, little egos are offended at being lower on the totem pole (yes, I know, on a real totem pole, the one at the bottom is king), then grow up, get the education you need, and become a doctor or nurse yourself!
As much as I love the Rabbi’s weekly podcast and Thought Tools (as well as your TV show), YOUR musings are one of the true highlights of my week. G-d bless you both.
L’Chaim.
Good thoughts! This healthcare system has made it practically impossible for good doctor and nurses to do their job well. I enjoy your musings every time.
Your article is spot on as always. I share your frustration that many Americans do not value health as the greatest wealth. Litigious , rude behavior is most unhealthy.
I have retrained myself in widowed life as a HCA (Home Care Aide), and I respect the titles of Doctors and Nurses who have been focused in the health care field far longer than I have. People don’t really care how much you know until they know how much you care. I hope to exemplify this caregiving motto. I love reading your thoughts, Miss Susan. Thank you.
The same story could be said for those in the teaching profession. The whole system is shameful,
Ah – my homeschooling column is where I discuss teachers and the disaster of education in the United States. What specifically are you seeing?