- A blog post titled, "Keep insulting doctors,
"and good luck finding a physician
"in the next 10 years," recently went viral.
I'm talking about it on this week's Wednesday Checkup.
(upbeat music)
The blog written by Dr. Karen Sibert was done
in response to a couple of articles from the Washington Post
that refered to doctors as muggers and co-conspirators
trying to take money away from the rest of us.
Dr. Sibert completely disagreed with that.
So I decided to talk about her article,
as well as interview her in this video.
But first, let me give you my take
on what's going on in our community.
I certainly do feel that there's a growing anx
against the medical profession, specifically doctors.
I think this anx really does correlate
with the spike in healthcare costs
and the lack of transparency from the industry.
I very much agree with this.
I think health care costs are out of control,
but I do not think that doctors are the main problem at all.
I think the real problem lies with Big Pharma
charging whatever they want for their medications.
Insurance companies and their lack of transparency
for what's covered and what's not.
Some of these prices are absolutely out of control.
Second is the consolidations and the mergers
that are happening.
I feel like when you have a giant like CVS and Aetna merger,
or Walmart and Humana, were promised lower prices
and better outcomes, but we get the same outcomes
and sometimes higher prices, and this is never checked upon
by anybody in the government.
And the biggest problem, the one that we talk least about
is the spike in administrative costs.
Let's put this in perspective.
In the US, we spend about 30, 31% of our healthcare dollars
on administrative costs, in Canada, it's 16%.
Half of what we spend, we actually have
the highest administrative costs
in health care in the world.
The reason for that, is our healthcare system
is an absolute mess, it's so complex and non transparent,
that you don't know what you're paying for,
insurance companies don't know what they pay for,
doctors don't know what treatments costs.
There's been so many times that a patient
comes into my office and asks me a very simple question
like, "Doctor, what will this medicine cost?"
Usually I can answer that.
But if they say, what about this MRI?
What about this physical therapy?
What about this sub specialist?
I don't know.
And my training is in taking care of that patient's life,
knowing the medicine behind it, not the billing practices
and these complicated ever changing insurance policies.
Also, while the administrative burden
contributes to increased costs, it also contributes
to burnout in the medical profession.
Doctors have the highest suicide rate amongst any profession
in the US, military included.
A big contributor to this is the administrative burden.
There's many things that doctors are now having to do
that they never were a trained to do
or wanted to do in the first place.
Electronic Health Records, prior authorizations,
dealing with insurance companies, to argue for care
that their patients desperately need.
Being a doctor is already a high stress job.
Making the mistake, whether you're a primary care doctor
or a surgeon, can mean life or death for your patient.
And when you sprinkle some extra fuel on that fire,
from an administrative burden sake and even misinformation
from economists and newspapers, to then fuel
hate towards us, that really makes the profession
less valuable in our eyes, and it contributes
to less individuals wanting to go into medicine.
Look, you have to give up over a decade of your life
to go study it, hundreds of thousands of dollars,
a strong, intense passion and skill.
You can do a lot of other things
and make great money, than be a doctor.
The reason we do it is because we want to help people.
We want to have the public's trust,
we want to do the right thing.
But if we're constantly being treated as if we're doing
the wrong thing, there's less respect,
we're being paid less, who's ever going to want
to become a doctor?
Before we jump into the interview with Dr. Sibert,
I want to summarize the main points
that she made in her article.
First and foremost, she's upset that people are criticizing
the medical field without truly understanding it.
Those are economists, journalists, they don't understand
the nuance that goes into being a doctor
and what medical practice is like for us.
Completely agree with that.
Second, she goes on to explain, that being a doctor
is a high stress job, whether you're a resident, an intern,
a family, medicine doctor or a surgeon,
there's life or death decisions that are to be made
every single day and most people cannot even fathom
what it's like to make those decisions.
Her third and final point, and her biggest concern
is that there's a growing number of doctors
leaving the field early.
And a growing shortage that's becoming evident
not just in primary care, but in sub specialties, as well.
Imagine going to the hospital trying to get care
and not getting it simply because there's not
enough doctors.
Without further ado, let's jump into the interview.
How's it going?
- Very well, thanks.
How are you?
- Well, you certainly got a lot of popularity
with this video, this blog of yours.
How do you feel about it?
- It was certainly a surprise.
I've been blogging for years, but I've never monetized it
and never really sought attention, but apparently
this struck a nerve and I have to say I'm happy to see it.
- What was your initial thought behind writing the article?
What did you want to happen?
- I didn't expect anything to happen.
I simply had an opinion to express
and this means of expressing it.
My husband always says, "Karen thinks everyone
"is entitled to her opinion," which he's not wrong.
But I do feel as though, I'm a well trained writer,
and sometimes I can express things more effectively
than other physicians can.
So I try to use that skill, as best I can.
What prompted me really to write it was, just feeling
outraged at the use of the word mugger (chuckles).
- Sure.
- That's just over the top.
The surgeon probably could have handled
the situation better, in the case of the patient
with the out of network bill.
But on the other hand, physicians are criticized
when they don't disclose up front,
that they're out of network.
So there were so many things, that I felt were unbalanced,
unfair and really vilifying physicians, in a way
that we don't deserve to be vilified.
- If you had to give a takeaway, not necessarily
to the physician audience or the medical professionally,
but to the layperson, the person that goes
to their doctor, is unsure why costs are going up,
why insurances are going up, what message
would you like to get out to them?
- Your doctors have worked really hard and really long
to train to take care of you.
That's what we want to do is take care of you.
We are not the enemy.
We are, in fact a tiny, tiny percentage
of overall health care costs.
The insurance companies, have their own side of this,
but they have gotten so big.
United Health posted a $14 billion profit last year.
The CEO of Anthem, which runs Blue Cross Blue Shield,
made $14 million in salary last year.
I don't know any clinical physician on the front lines
that makes a fraction of that.
We are really not the source of the problem.
And thinking that we are, makes you think of us
as not on your side, we are definitively on your side
and we want nothing more than to take care of you.
The second point, which I did try to make
in the article, is that ours is a stressful line of work.
If you think that we're really taking off
Wednesday afternoon to play golf, I don't even know
where that stereotype came from, but it's hilarious,
I mean, who does that?
Nobody?
Nobody does that (chuckles), that's crazy.
We work nights we work weekends.
My son is a third year internal medicine resident right now.
Nobody wants to know how hard and how long he works
this eight hour workweek, okay, not really, not really true.
- Why do you think doctors are not great advocates
for themselves to defend themselves from this critique,
I feel that we're either forced ourselves into silence,
we think that this is not our battle to convince patients
that we're out for them.
Why is it that we have this disadvantage do you think?
- I would agree with both of those, both of your comments.
We were brought up to be professionals.
50 years ago, physicians didn't advertise,
they would have thought it was beneath their dignity
to advertise.
Now, if you're not on social media,
if you're not putting yourself forward,
you really are hiding your light under a bushel,
and no one is going to know what you do.
But the holdover from that is still very prevalent.
We feel, frankly, that it's beneath our dignity, often,
to try to defend ourselves.
We feel as though we should be better than that.
But in this situation, I think I was compelled to write
because I wasn't defending myself, I was defending
everyone else and that was why I wanted to give a shout out
to the family practice physicians, to the interns
and the residents to all the people,
we're all in this together, nobody does this alone.
- The title of your article is keep insulting doctors,
and then in 10 years, there may not be enough doctors,
something along those lines. - [Dr. Sibert] Right.
- What do you, why do you worry that in the next 10 years,
we may have a shortage, that's not only due
to a lack of people going into medicine
because of the difficulty of the field,
but also specifically because of the insults
that we're receiving.
- People who go into medicine are smart,
they're hard workers, they're very motivated.
They have other choices, I'll just put it bluntly.
So if you see, if you pay attention, and you see
what's going on, you might very well say to yourself,
as a bright young college student, "Do I need this?"
The other point is that, there's a huge emphasis today
on work life balance, and I don't blame
people for that, my generation was not brought up that way,
but it's very much a generational thing.
However, if doctors are avoiding professions
like vascular surgery, neurosurgery, invasive cardiology,
heart surgery because of the length of training
and the long hours, and the, suffering that's involved
in attaining proficiency at those levels.
We're not going to have people going into those fields.
They were up to about 50% of women in medical schools now,
but the number of women that go into those fields
is vanishingly small.
Even in my profession, people want jobs
and outpatient surgery centers, they want no nights,
no weekends, they don't want to do what I do,
which is thoracic anesthesiology, which involves
taking sick patients with lung disease and ventilating
only one of their lungs while the surgeon
operates on the other.
It's stressful, it takes a lot of proficiency.
People don't want to work that hard.
So even if we graduate more medical students,
right now, the government isn't funding
enough residency positions, to train them all in specialties
because resident funding hasn't increased since 1979.
- Is there any last messages you'd like to get out
to the YouTube community?
- To the YouTube community, your doctors really actually
love you and want to take care of you.
So work with us, eat healthy, exercise, don't smoke,
stay out of the sun, and we will in turn, keep working
on your behalf because we really do care.
- Thank you so much doctor, very much appreciate
your time. - Thank you.
- Bye bye. - Bye bye.
- After speaking with Dr. Sibert, and thinking about
this article on my own, I've come to the conclusion
that doctors can really advocate better for themselves.
We have a role to play in this situation.
We need to not just sit back and listen to people,
bad mouth or industry and talk about us being muggers
and co conspirators, we truly do care about our patients
and we want to do better.
I think doctors need not be afraid, to step outside
their comfort zones and let their voices be heard.
Explain to the general public, the nuances
of being a doctor, the difficulties that we face
with administrative burdens, ways that we can do that,
go on the news, write a blog like Dr. Sibert,
have a YouTube channel, Dr. Mike.
If you want to check out more of my medical videos,
click here for this playlist,
I've put some together special for you.
Let's watch it together, you know, being happy and healthy.
(upbeat music)