Physicians abused, ignored and silenced no more

Editor’s Note:  The following is an excerpt from a speech given at the Philadelphia County Medical Society during a nationwide “Day of Solidarity” to prevent physician suicide by concerned medical students, residents and attending physicians, led by Pamela Wible, MD, an author and expert on physician suicide.

We come to the MD-allopathic and DO-osteopathic medical physician professions as I did, young, bright-eyed, bushytailed, smart and compassionate, aspiring to do well by helping others. We are independent thinkers, creatively solving problems. We are driven by our sheer force of will, illuminated by our unique individual internal light and guided by our internal compass. 

Related: Top 9 MACRA threats that could become reality for doctors, patients

Through medical school, internship, residency and medical practice as an attending, there are many dark times caused by external political, power and economic forces that threaten our internal light, force of will and ability to heal. It is generally reported that we lose on the order of 400 physicians to suicide each year, or a physician dead every day. 

Recent articles written on "physician burnout" miss the point.  Physician burnout is a misnomer, it is the result of externally imposed abuses; to paraphrase Dr. Pamela Wible. In other words, don't blame the victim for the crime. 

Today, we stand in solidarity against the causes of physician suicide. We must shine a light on the causes and either force them to change or make them irrelevant. 

Next: Abused by the system

Students interns, residents and attending physicians are abused, ignored, and silenced:

• Abused by a system that buries us in debt and keeps us there; half million dollars in training debt to start.

Related: What is the price of physician stress and burnout?

• Abused by schools and training programs that create compliant technicians instead of independent caring physicians; 

• Abused by a system that hazes like a fraternity's hell week but lasts for decades; 
• Abused by long hours keeping us up all night on call with patient lives resting in our exhausted hands; 
• Abused by a system infiltrated by third-party profiteers, who abandon us and patients in the name of profit-insurance companies, third party administrators, health IT companies, and the like…;
• Abused by a system regulated to death, unfortunate pun intended, by federal government bodies and programs;
• Abused by a system that ties and buries its victims in red tape, like ACA, MU, MACRA, MIPS and all other killer acronyms, till breathing stops, and eventually, heart beating stops. The silence is deafening. 

Further reading: It's time to get doctors out of EHR data entry

• Ignored by a top down system that puts data management over people, and compliance over care;
• Ignored by a system demanding Pres-Gainey scores, so-called "quality" scores, online reviews and Facebook likes …;  

• Ignored are our talents and creativity in order to force the same cookie-cutter guidelines as recipes for all tasks; 

Next: Silenced by the government

• Ignored are our 11-plus year college, graduate, post graduate and ongoing continuing medical education in order to promote "medical care" by non-physicians degrading the quality of care well delegating all their practice risk to physicians; 

• Ignored are our cries for honesty, transparency, empathy and help.  

• Silenced by hospital health system's sham peer reviews that are witch hunts in disguise, ruining jobs and even whole careers;  
• Silenced by employers that value ratings and reimbursement over human lives, both patients' and our own. 

• Silenced by professional medical organizations that don't represent physician and patient interests but openly advocate expensive, needless maintenance of certification programs, and third-party and government care rationing schemes over the objections of the member physicians; 

Further reading: How to avoid the corrosive effects of physician burnout

• Silenced by federal government programs [under] HHS [and] CMS …which treat physicians as guilty until proven innocent after the work was done for patients in good faith. 

No more will we allow our dreams and plans to be crushed to dust by unfeeling administrators. No longer will our self- care or patient care be thwarted by bureaucrats for power, money, politics or votes. No more will physicians pushed to suicide. Today we all stand together in solidarity to stop the shameful and preventable loss of life. We say "no more!"

First, physician, heal thyself. Stand up and speak up. We must care for ourselves as individuals. Our daily personal health has to be paramount, before we can care for others effectively. We must be the change we wish to see in the world with a plant-based diet, daily exercise, drinking water, avoiding toxins and nourishing a healthy positive attitude. 

Next: "We must preserve and maintain the right to independent medical practice"

Second, we must preserve and maintain the right to independent medical practice. Medical schools and residencies must teach direct care and direct primary care. It is commonly known that, "you cannot serve two masters." We can't serve patients' needs last after serving the "uniform guidelines" dictated by the federal government, state government, insurance industry, third-party administrators, hospital health system employers, so-called medical organizations, heartless residency programs and soulless medical schools. 

Related: Physician wellness is a quality measure worth measuring

Third, we must fight unjust government regulations that limit our ability to care for ourselves and the patients we serve. 

We cannot and will not allow physicians to be driven to suicide in total darkness and despair by government compliance tyranny, training hazing and third-party money interests. We must shed light on all causes of the problem and take decisive immediate action. This is the real "Sunshine Act” [seeking illumination and action].

Abused. Ignored. Silenced. No More!