I think a lot about the slow, certain dissolution of medicine as we know it.  Mental health issues crowd emergency departments, as few mental health clinics are available.  Psychiatrists are in short supply.  Drug abuse overwhelms the medical system, with either patients seeking pills or patients families hoping to get them off of pills.

Persons with little interest in their own health continue to smoke and drink, use Meth and eat poorly.  Disability claims are skyrocketing as younger and younger individuals confabulate their misery in hopes of attaining a check, paid for by someone else.

The poor, with genuine medical problems, have increasing difficulty finding care as jobs, and insurance, fade away.  Politicians, eager to be re-elected, eager to be loved, promise more and supply less, and consistently refuse to address tort reform.

Federal law has overwhelmed emergency departments and hospitals in general by requiring them to see everyone, regardless of ability (or intent) to pay.  Hospitals and emergency departments, fiscally crushed, have closed and continue to close.  Our hospital is deeply in the red due to charity care and uncompensated care.

Specialists are fleeing in droves.  It is harder, and harder, for small hospitals (and even large ones) to find psychiatrists, neurologists, surgeons, ophthalmologists and others.  I understand why they’re scarce; they are asked to do a great deal with great risk of litigation and no promise of compensation.

What do we do?  I wonder how long it can go on like this.  But I hope that all of us in medicine can do one simple thing, even as we reasonably try to find ways to make medical practice work from an economic standpoint.

I hope we can remember this:

Do unto others as you would have others do unto your children.

It may sound ‘pie in the sky,’ and it may sound simplistic, but the point is that all of our children, all of those we love, will eventually need care; often in a crisis.

Everyone has to be sensitive to this issue; every physician has to be aware of the enormous need for care, even as care evaporates.  There is no policy or plan, no governmental intervention, no fiscal ideology that will accomplish what a change in hearts can.

Let’s all be careful to protect the vulnerable, the ill, the broken.  Let’s make ourselves available when they are injured or ill, rather than always assuming someone else will do it, or that ‘it’s not my problem.’  Maybe, with acts of compassion and love, with genuine interest in the well-being of those to whom we have no actual responsibility, we will be able to transform medicine.  Maybe, if we do the right thing, we as physicians can take control of it again, for the good of all.

Just a thought.


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