We must work together to save health care in our country
To the Editor: Dr. Lansdale’s comments sadly illustrate all that is wrong with our health care system.1 Desperately ill patients are hospitalized for as few days as possible in order to receive substandard care from agency nurses. Physicians have become assembly-line workers who must order large batteries of tests and procedures because they don’t have the time to sit down, talk to, or examine their patients. This is the type of care that medical students, interns, and residents are learning to practice. Sadly, this is the type of care that patients now expect: an MRI provides better reassurance than a physician’s competent assessment. Business, not physicians, dictates how medicine is practiced.
Internists who care about quality, like Dr. Lansdale, are leaving the profession in droves. But rather than passively leave, they should become leaders in an effort to reclaim health care. If internists worked together, they might be able to enact major changes rather than passively watch as the ship sinks under them. There have been calls to do something.2
Some physicians are taking matters into their own hands by opting out of the system altogether; they no longer accept any type of insurance. While extreme, if done en masse this option could send a powerful message to policy makers and insurers that physicians will be pawns no longer. If physicians do decide to do this, they should make every effort to keep fees, tests, and procedures to a minimum in order to reduce costs.
The United States stands head and shoulders above all other industrialized countries in per-capita spending on health care.3 This level of spending is not sustainable, especially in a nation beset by worsening financial conditions. 4 The United States desperately needs its physicians to be leaders in addressing our health care woes. We must work together to save health care in our country: quitting should not be an option.