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Eye on the prize

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Imagine: the freedom to care for patients the way you want to, not the way insurance mandates or regulations require.

Editor's Note: Physicians Practice’s blog features contributions from members of the medical community. These blogs are an opportunity for professionals 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 are that of the writers and do not necessarily reflect the opinions of Physicians Practice or UBM.

Several years ago, when one of the multistate lottery prizes was at an all-time high, a much wealthier physician sat me down to tell me what to do with my imaginary winnings. Funny, since I didn’t even have a ticket yet. But he, apparently having experience as well as several million dollars, had plenty of advice on what I should do if I come upon a few extra millions of my own.

Recently, someone asked a group of physicians if we would still work if we won the lottery. The answers were mixed. Some unequivocally said no, others said yes, and the majority of us said that we would still work-just not in the way we are working now.

Generally speaking, I think physicians are ambitious, driven people. We have spent most of our adolescence and young adulthood striving for excellent grades. We compete for residency and fellowship slots. Once there, we work hard to prove ourselves competent. We enjoy challenges. Some might even say we thrive on them.

Of course, we enjoy our time off, but not many physicians are people of leisure. The thought of not having something to get up for in the morning seems foreign to us. After all, most of us entered the profession with at least some form of altruism. One of the most common answers students give during medical school interviews when asked, “Why do you want to be a doctor?” is “to help people.” So, suddenly skipping out on our patients because we won a windfall is also not in our nature.

On the other hand, the practice of medicine in the United States is also not what most of us signed up for. We wanted to see patients, help people, and make a decent living doing so. Instead, we have been degraded to providers, basically hired help. Regulatory requirements are increasing our workload without any benefit to patients or physicians. Insurance companies interfere with the physician-patient relationship. We are forced to see more patients in less time and yet are asked to document more during those visits. Ah, if only we could spend time with them, talk to them, educate them, and hold their hands. If we could provide them with the care they need without worrying about proper coding.

Alas, although I did buy a lottery ticket that day and periodically since, I have yet to win enough to change the way I work or, for that matter, even buy a cup of coffee. I would love to have enough money that would allow me to provide care to patients without worrying how I am going to pay the staff or the rent. Enough money that would let me see the uninsured for free. Enough money that would let me help patients get the medications they need regardless of what their insurance company says. Yes, I would still work. But I would work my way, the way I wanted to ever since I decided to become a physician.

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