Advice for a Frustrated Gastroenterologist

“I’m a gastroenterologist in practice for four years and frustrated, hopelessly unfulfilled with modern health care. I’ve even contemplated leaving practice. I love medicine and treating patients but I’m sick of the headaches of running a business and worrying about what insurance, if any, people may have. Thanks for your advice.”

Another day. Another urgent plea from a doctor.

I was once a discouraged doctor. I dreamed of returning to my college waitressing job just so I could be nice to people again. It is the patient relationship that is the greatest source of professional satisfaction for most physicians. So it is no surprise that assembly-line medicine fails us. Production-driven health care is an oxymoron.

The good news for my frustrated colleague is that we live in an era of transparency. Disintermediation or “cutting out the middleman” allows modern businesses such as eBay and Amazon to build direct relationships with clients. Even in medicine removing intermediaries saves money and renews patient-physician relationships.

Gandhi advises: “You must be the change you wish to see in the world.” Now is the time for innovation.

If you are sick of the headaches of running a business, remember medicine is a calling. Revision your practice. Align with your values. Simplify and find meaning.

Here’s my advice for the top five physician morale-busters:

1) Low reimbursement? Drop bad payors and provide cash discounts. Lower overhead; you’ll need less revenue: Expensive building? Downsize. High staff-physician ratio? Consider part-time employees; streamline tasks with technology.

2) Loss of autonomy? Limit bureaucracy. Scrutinize third party contracts and terminate burdensome relationships. Say goodbye to middlemen who undermine your ability to care for patients. It may be difficult–like leaving an abusive marriage–but I promise you’ll never look back.

3) Patient overload? Take care of yourself. Every stewardess warns: Put your oxygen mask on first then help your child. Empathy burnout and physician fatigue have real consequences. I recently read 20% more polyps are identified on colonoscopies performed before eleven in the morning.

4) Loss of respect? Safeguard patient relationships and enjoy renewed respect and appreciation.

5) Malpractice worries? The sacred patient-physician covenant is your best protection. Patients don’t sue doctors they like.

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