Kevin MD references a posting on what life is like for a hospitalist at Kaiser that tells the readers more than what life is like for a hospitalist at that particular HMO.The blog that Kevin refers to is EM Physician-Back Stage Pass and here is the essay.
I believe it tells a great deal about what may be a major paradigm shift in the self image or mind set of physicians in this new culture of managed care.
Here is a quote:
Medical students and residents are seeking a better lifestyle for themselves. I guess we're finally coming to realization as a group that medicine isn't worth your happiness and sanity. That it's hardly admirable to subject yourself to abuse (by CMS, by DHA, by joint commissions,by society by medicine) and be absent in the lives of your loved one. Maybe when doctors were respected,autonomous and paid well...but now,not as much. when this happens, when docs start seeing themselves as employees with jobs,continuity of care sounds like crazy talk. Think how crazy it would sound if we suggested that nurse (or anyone else on the 'healthcare team' were made to "feel guilty" about going home at night....Everyone has a job these days..which is what government created and physicians (at least the professional societies) have allowed to happen.
The loss of pride that DrRich and I have blogged about seems evident in this doctor's view. It seems the doctor author sees himself as 'only" an employee. I re-read his piece and I go back and re-read the an early entry I submitted for this blog which dealt with the transformation of a lay person to a physician and at first conclude that our views are miles and ages apart.Or maybe my views are what I was taught a physician should be and his/hers are what the reality of the current economic medical landscape are turning physicians into.