Unfortunately, for physicians who have dedicated their careers to patient care, they are besieged by the many ongoing uncertainties within the U.S. health care system, this summer, this year, and for the last decade(s), which have promulgated a great deal of apprehension as to how we can best “practice” our profession
Dr. Shore is medical director of Carolina Urologic Research Center, Myrtle Beach, SC.
“Summertime and the living is easy,” goes the classic song. Unfortunately, for physicians who have dedicated their careers to patient care, they are besieged by the many ongoing uncertainties within the U.S. health care system, this summer, this year, and for the last decade(s), which have promulgated a great deal of apprehension as to how we can best “practice” our profession. There is no clear roadmap or easy pathway to ensure that we can maintain a high level of practice, a high level of efficiency, and a high level of humanity that all practicing physicians aspire toward.
Let’s review just a few of the challenging issues that threaten our traditional physician-patient relationship. We have a severe shortage of well-trained urologists within the U.S., in conjunction with an aging population of practicing, board-certified urologists and an ever-expanding and aging U.S. population. We have the looming sustainable growth rate (a perennial sword of Damocles) as well as diminishing reimbursement policies without a concomitant decline in overhead requirements (human resources, rent, insurance mandates, etc.).
Those of us who are still practicing independent medicine are continuously threatened by corporate health care-both for-profit and non-profit hospital systems-and the ever-expanding health care concerns that relegate the hired/salaried physician to the role of high-tech laborer with no personal stake in the system’s long-term growth. Certainly, we have now been ensconced by the electronic invasion and capture of the health care system despite the vast majority of physicians being hard-pressed to heap praise or ballyhoo its arrival as having improved their enjoyment of medical practice nor cite its enhancement of the patient-physician interaction. (Remember to not turn your back while typing and don’t forget the importance of keeping eye contact, although this may become less critical with the younger generation of patients.)
That said, and despite the negativity of the above statements, medicine (and urology in particular) is still an awesome career and a privilege to all who choose to practice this hallowed and revered profession. Nonetheless, we have real challenges intertwining with exceptional diagnostic and therapeutic advances. I plan to write about these issues in future blog posts and sincerely welcome feedback, criticism, and opinion so that we can openly confront the changing and challenging times before us, and reflect on another lyric from that immortal tune: ”…no need to cry, don’t cry, don’t cry, summertime, summertime…”.