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Bankrupt Healthcare
Doctors Are Becoming Suicidal and Depressed

Suicide, depression, mass exodus—these are all increasingly hallmarks of a profession that the American public consistently ranks among the most trusted and admired. The Daily Beast profiles the sagging spirits of doctors, who feel increasingly hassled by byzantine insurance regulations, long hours filling out forms, excessive patient loads, and burdensome testing and re-testing mandated by medical boards. More:

What worries many doctors…is that the Affordable Care Act has codified this broken system into law. While forcing everyone to buy health insurance, ACA might have mandated a uniform or streamlined claims procedure that would have gone a long way to improving access to care. As Malcolm Gladwell noted, “You don’t train someone for all of those years in [medicine]… and then have them run a claims processing operation for insurance companies.”

In fact, difficulty dealing with insurers has caused many physicians to close their practices and become employees. But for patients, seeing an employed doctor doesn’t give them more time with the doctor—since employed physicians also have high patient loads. “A panel size of 2,000 to 2,500 patients is too many,” says Dr. Schimpff. That’s the number of patients primary care doctors typically are forced to carry—and that means seeing 24 or more patients a day…

As we’ve noted before, doctors are often at the mercy of the context they operate in. Leadership of medical guilds, policy decisions, and a third-party payer system seemingly immune to reform have all combined to force doctors to operate within a highly perverse system or leave the profession altogether. Patients and MDs alike lose out when doctors are overworked and in the dumps.

One way to help address this problem would be to drastically expand the number of health care providers in the system. This would reduce the workload per provider and free up doctors to make better use of their workdays. We already know how we can do this: allow nurse practitioners to provide more primary care, and reform medical school and residency programs. This would lower MD’s salaries, but it would also relieve them of many of the stresses making them so unhappy. To be sure, these reforms would have to be joined to others in a combined effort to streamline administrative processes, but even on their own, they would be an important start to curing what ails the medical profession.

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  • free_agent

    Of course, doctors (or at least, primary-care providers) are depressed. Their collective power is declining, and thus they have to work harder and get paid less.

  • Jim__L

    Being cogs in a machine is degrading and inhuman. Always has been, always will be.

    Big Government, Big Business, Big Anything — it maximizes the number of cogs.

    Breaking them all up is the only path to human dignity and independence.

  • Richard T

    Something tells me that most doctors are well aware they could make half as much money by seeing half as many patients. But there’s this perverse relationship between overwork and prestige. Who wants to be told that half the work they’ve been doing was unnecessary?

  • Anthony

    If doctor’s salaries are going to be reduced on a per patient basis – and this is clearly an objective that professor Mead favors – they will likely see more patients per day in an attempt to boost their incomes. In South Korea, for example, doctors don’t get paid much for an office visit, so they tend to work long hours and see many patients to get a high salary.

  • dbr1

    One theme that Mr. Mead brings up again and again and again: Doctors make too much money. There seems to be a deeper animus here.

    Maybe if he read this he would gain some perspective:

  • SisyphusRolls

    One thing that ACA seems to have been successful at is pushing doctors toward employment as part of medical groups. While I am strongly opposed to ACA generally, consolidation of doctors into firms where they can minimize their overhead and focus on their medical specialty, instead of billing and reimbursement, is long overdue.

    Now we just need a lot more doctors and a break-up of the AMA’s ability to set Medicare fees.

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