Dear doctor: What happened to us

January 17, 2019

We seem tired, unhealthy, and worse off than some of the patients asking us for help. Despite what you may think, complex and costly care didn’t zap our energy. The fatigue we feel comes from a lack of balance and connection in our own life.

Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The opinions expressed here are that of the authors and not UBM / Medical Economics.

Dear Doctor:

What happened to us? We seem tired, unhealthy, and worse off than some of the patients asking us for help. Despite what you may think, complex and costly care didn’t zap our energy. The fatigue we feel comes from a lack of balance and connection in our own life. I am a better physician since I realized medicine wasn’t my highest priority in life. Hard to love people in life like administrators and teenagers aren’t problems to fix. They are just people. Like us, their selfish desires are best helped by unmerited grace. The love we receive is the only love we can give to anyone. Make time for the areas of life you truly love and spend some time there. Compassion, understanding, and partnership flow from hearts that are filled up. We should have our hearts filled before we speak to people who are hurting. Remember, it is the patient’s room and we enter. In that room, simplicity, accuracy, and value are what it takes for the patient to move themselves in the healthy direction. Twenty years of seeing patients in the trenches of family medicine have taught me some lessons worth sharing with you.

Our great mentors taught simplicity can better disseminate the level of knowledge we doctors acquire to those without our degree. The information is already available on the web regarding what food or medicine is right for your patient. However, the good science is hidden by the layers of misinformation that government, poor research, and industries are allowed to produce. Why don’t you master the skill of finding it for them at the point of care? The inappropriate/expensive industry funded medical advice, paucity of leadership in healthcare systems, and deceptive food industry are just a few warriors you are up against in the war for good health. The battle, however, is won in this order:  listening, discernment, and then delivering small truths. Keep it simple and make it just enough for the unique person in the next exam room you walk in.

To improve accuracy, get a subscription to UpToDate. Open it up with any keyword you know about the diagnosis as the patient tells their story. In the room, jump to the treatment summary when you aren’t sure. Don’t assume, as I did, that this expert recommended medicine will be affordable for your patient. Suggest the free app GoodRx for the patient to use in finding the best pharmacy for generics. Print the prescription so he or she can have the leverage to shop around if insurance coverage is a factor. I believe healthcare will join us one day in making pricing and quality data more visible. Our hope for a better business model isn’t in healthcare systems. It is in the genius of the best businesses in the world. For instance, Google just created Oscar Health as an insurance company so they could get inside the healthcare system. They quickly realized it isn’t set up for quality, access, or cost control. Healthcare data is just about getting paid. They created an Oscar app for patients that works like Uber. Healthcare navigation from point A to B will be cheaper, more accessible, and of better quality very soon. 

Weave the value of better nutrition into your plan too. The food pyramid is counter to Hippocrates who said, “Let your food be your medicine.” Those daily servings of processed foods and inappropriately farmed foods are the problem and not the solution. Grains became the foundation of our food pyramid because those lobbyists represented the highest bidder. Plant based foods are shipped green from far away and gassed to look healthy. They high in lectins and are not good habits. Accept that this ridiculous pyramid was built to sell food and this misinformation contributes to the obesity epidemic.  

Now, share the truths that help your own body stay healthy. Timeless principles of intermittent fasting, portion control, vine ripe, sustainable animal farming, are good places to start.  One day a graphic designer with your same passion for others (who isn’t beneath you) will design a more memorable image full of health giving suggestions. Share those little life giving terms for meat shopping like “grass fed beef”, “wild caught seafood”, and “free range” poultry products whenever you can. Don’t give in to vegetarianism which is no fun at parties and just raises lectin intake which is worse than appropriately raised meat for most people.

You thought your pathology textbook was confusing? Try reading food labels or making a shopping list after a full day at work, with no medical degree, and with hungry kids in tow. If eating well is difficult, how are these sweet patients to know what supplements, workouts, or preventive medicine steps to take until we tell them? They weren’t able to quit working like us and pour themselves into learning about the science of health. Let’s do our part in making healthcare more simple, accurate, and full of value. The government and business sectors will see what we do and have to follow suit. Don’t let the administrators or politicians divide us. The belief in togetherness is what drove us to this calling and can help get your work life back on track.

I started my journey to medical school 28 years ago with a dream that a good doctor can be a small light in this world. It is such an honor to be there for others that I wonder why they pay me . . . sometimes. 

I want you to know there are more riches and reward in the relationships you build than in the bank that receives your paycheck. Please remember it wasn’t medical school or residency that made you who you are. It was and will continue to be experiences with your loved ones, your unique gifts, and the hand of Providence. Stay balanced and connected along the way. Give all you can to your patients and team members at work. However, don’t put your career in the top three items of your life’s priority list. At my offices we strive for these ideals. Patients are astounded how helpful we are to them. 

Let’s aspire together to not look so much more amazing than the next doctor. If you stand out that much in medicine it means your “competition” is far behind and that isn’t good for the community. (I would argue that doctors should let business minds waste their time with words like competition). Work a little less but don’t quit. May we continue to lose our problems, and, therefore gain our energy in the great care of others.