In a recent stay in the hospital for an aging ticker, an interesting doctor with whom I had a discussion told me that physicians today are rapidly being reduced to mere technicians. Technicians who must rapidly and exactly obey what treatement paramaters that (often distant) “experts” dictate will be allowed to be applied, or not applied in any given case, whether on an outpatient basis or in Emergency Rooms.

In fact, he said, traditional-minded physicians themselves are being practically phased out everwhere, replaced by obedient Nurse Practitioner drones; and physicians, more and more often, and will not be found even in Intensive Critical Care Units, except over a teleconference screen. No personal touch involved.

No personal touch involved? He looked at me to see if that registered, which it certainly did.

“Practicing medicine until not long ago, used to be an art,” he said. “We doctors became good at what we did by observing and experiencing the same medical situations and interventions over and over and over, improving our treatment techniques as we went along over time, and by learning from hands-on mentors. If we were stumped over a medical problem or anomaly we had colleagues close by whom we could consult, colleagues who would often interrupt their day to rush to a telephone or to the join us at bedside.”

Today, he said, those colleagues increasingly are not allowed to do that. Options are dictated from on high by bureaucrats who have never seen a patient and who only watch the ‘bottom line’. Time is money for them. Everything is increasingly dictated by Playbooks written with that sole bottom line in mind.

“I’ve seen more and more often today,” he said, “that as many as twenty Nurse Practitioners will answer to one physician who seldom or never sees the patient. This is happening.”

So, fewer and fewer physicians palpate an abdomen, examine the eyes, ask critical questions, or otherwise personally examine the thousand other intangibles, which, along with bloodwork, give the telltale signs which determine how to proceed.

He said saving lives used to matter. But today boards of directors increasingly look at mortality rates as a money issue. “I know CEOs who run hospitals, Supermarkets and other businesses all together. And the approach is always the same. Business is business”.

Patients with serious illnesses are ejected from hospital beds faster than they can process what has happened to them; so even rest and convalesence has largely become a thing of the past. Swift rotations of patients is the key to money on this assembly line.

He said he advised his children not to go into medicine today. “At least don’t go into it for the reasons I did when I went to medical school.” Back then, he said, it was always seen as a service of compassion. Today it’s about how CEOs define “efficiency…bottom line efficiency”.

It’s getting cold out there.

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