Anonymous Doctor

Hey, a beacon of light from today's New York Times. Hard to feel bad about the work you do when you read stuff like this. An article (link here) about a psychiatrist who has stopped providing talk therapy because insurance companies won't pay enough, and now all he does is 15-minute visits to write prescriptions for meds.

It's an appalling article, not so much because the doctor feels conflicted about the limited service he's able to provide in order to make a living-- but because he doesn't really seem to be very conflicted at all. At least he's aware that he's turned his practice into a medication mill. His wife (and office manager) seems to lack any compassion or self-awareness entirely, if her quotes are representative.

Some bits from the piece:

"He now resists helping patients to manage their lives better. “I had to train myself not to get too interested in their problems,”"

He could have accepted less money and could have provided time to patients even when insurers did not pay, but, he said, “I want to retire with the lifestyle that my wife and I have been living for the last 40 years.”

[Y]ears ago, he often saw patients 10 or more times before arriving at a diagnosis. Now, he makes that decision in the first 45-minute visit. “You have to have a diagnosis to get paid,” he said with a shrug. “I play the game.”

“The sad thing is that I’m very important to them, but I barely know them,” he said.

I get some of this is necessary-- or at least necessary if you want to make as much money as you can-- but at least feel ashamed of yourself, right? Being a doctor isn't the same as being a guy who pushes paper in an office, it just isn't. You can't process a patient the same way you can process a tax return. Yes, there are things about the system that suck. And residents are sheltered from the concerns of insurance companies and reimbursement. But how can you not feel profoundly ashamed of yourself to be a psychiatrist who refuses to listen to his patient's problems and won't even try to squeeze someone in when they're having an emergency?

If you want to be rich, be a specialist. Perform procedures. Align your practice with the kinds of work that insurance companies pay for. This way you can serve your patients and at the same time make the kind of money you want to make. But I don't think it's fair to your patients to become a psychiatrist and then decide that the competent practice of psychiatry won't make you rich enough, so you have to cut corners.

Maybe this is a naive reaction to the article. I mean, I feel like I'm usually inclined to sympathize in the other direction and then deal with commenters who say I'm proof that doctors are terrible. So if I'm feeling like this guy is a joke... I'm guessing you have words even harsher in mind.

My biggest question though-- why did he agree to this interview? Can anyone possibly read this article and think, hey, I want *THIS GUY* to be my doctor! It's like he's *TRYING* to sabotage his practice!

Enough from me. Read the piece. Tell me what you think.

Oh, and while I'm at it-- I threw that Facebook "Like" button up on the right-hand column of the blog a while back and can't tell if anyone has ever clicked on it. If you like the blog, do me a favor and click on the button if you don't mind. I don't know quite what it does, but I figure it might be neat to find out. Thanks.