Medical student: “They’re training us to abuse patients in assembly-line clinics.”


Dear Dr. Wible, 

So I just walked out of clinic today and I have to tell you I feel awful. Just awful. I was so excited to work at this particular clinic and now having seen how we went through patients like they were scraps to be tossed out, it is so disheartening. 

The doc I was working with was lovely. She was very nice. But she kept telling me that I was making the “classic mistake of trying to ask patients about their problems” (!!!) apparently we don’t have time for that.

Another doctor told me, ”you only get sued if you are an asshole, so always pretend to be interested.” My mentors are kind, but they’re also so disconnected. They were clicking through visit logs to point out the “slacker” docs with 25 patients in an afternoon because we saw 30. 

I just can’t. Holy crap.

I can’t imagine practicing like that, celebrating the fact that we went in told someone they had diabetes to go “lose weight” and walk out 5 minutes later and we’re supposed to be proud of ourselves for efficiency?Completely brush off the trauma a patient is telling us about her rape and PTSD because whatever we don’t have time. 

It just kept going and going.

I felt like breaking down and crying every time I walked out of a room. How could I possibly be okay with turning my back on these people so grateful to see us?? But  honestly now I’m just terrified. Of residency. I always knew it would be like that, and I do want to do it and get board certified, but holy crap. How could I ever survive that?  

Eventually I’ll open my own clinic, you’ve inspired me too, but I always felt like I want to “work” for a bit, get comfortable with being a full-fledged doctor, and have a steady salary and savings before plunging into opening my own clinic. That I could just “survive” residency the way I’ve been surviving med school, but now it sounds awful. Is there really a residency that won’t crush my soul??

Sorry for ranting. I just needed to vent, but I’m alone in California on this internal medicine rotation and I know you will understand. They’re just training us to abuse patients in assembly-line clinics.

Thank you for being a shining light, and a great example. Without the hope of my own ideal clinic someday, there’s no way I could do this.

~ Jonathan

* * *

Hey Jonathan,

My best advice is to open your ideal clinic as soon as possible. Do not delay. Every day you wait, you continue to support this sick system that abuses you—and your patients. If you are a true healer, you can no longer be a victim. You must stand up for human rights. Yours. And your patients. 

I’m here if you need help. . . .

~ Pamela

P.S.  These videos with totally inspire you! Don’t let your job suck the life out of you and How 4 doctors found their dream clinics (and you can too!)

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12 comments on “Medical student: “They’re training us to abuse patients in assembly-line clinics.”
  1. Anon says:

    This is exactly what I went through in med school and residency.
    Does anyone think the culture of medicine will change soon? In our lifetimes? How do we do it?

    • Pamela Wible MD says:

      Yes! It absolutely will change in our lifetimes. When outrage overtakes apathy we will have change. The public is on our side. All we need to do is tell the truth. It really is that simple. Silence will not save us. Secrets will not save us. Share your truth. Share your stories. One person who tells the truth can change the world. Many people who tell the truth will increase the velocity of that change. It’s not a matter of if we will see this in our lifetimes. It’s when. Please tell your story (even anonymously) and share this:

  2. Kevin L. Sullivan says:

    I have been a RN for 38 years and I have seen this behavior time and time again. This is violence usually against the nurse, but also it against any what the physician feels is an “underling”. there was even a case that in my presence that a MD hit a surgical tech. I have also been told by one doctor after I confronted him on his behavior “They would gladly get rid of a nurse than punish a doctor”.
    in addition hospital administration does not care and will not do anything.
    I really feel for the residents that must endure this treatment. Reporting abusive treatment is a career limiting move and can ruin so many years of work. All healthcare professions seem to “eat their young”
    Not until criminal charges are filed against docs who throw OR hardware or threaten anybody will this behavior stop.

  3. Mitchell says:

    Jonathan- start facing reality. While you are on rotation, they are paying your med mal, paying for the upkeep of the clinic, the computer contract, the EHR, and your salary etc. When you get out into the real world and find out that there is a +50% overhead on “your ideal clinic”, and you have to pay taxes on the gross, you will see as many people as you can. Insurance companies are paying less every year, but the cost of toilet paper in the patient bathroom goes up every year!! See as many people as you can and hope you don’t drop the ball some where.

  4. Olga karantoni, MD, MA says:

    You are absolutely right. Healthcare should still be about “Care”, a genuine feeling of purpose to improve people’s lives, to improve the way we practice medicine for the benefit of all, not just for the insurance companies to make money.
    We should all care because we are all going to be patients at one point or another. And when you are a patient you can see the disconnect and disillusionment of doctors towards the patients.
    Doctors should be held at higher ethical standards. let’s elevate our profession to where it should be.

  5. Sarah Bearden says:

    I want my Primary Care physician to be Jonathan! (And I’ll bet there are a ton of patients more like me).

  6. Linda de Cossart says:

    Thank you for this. In the U.K. we run education programmes to teach medical teachers to understand that education and medical practice have a moral responsibility to develop the person and ensure their flourishing (as patient and doctor) the future depends on them doing this. Humans not machines.

  7. JoAnne Raatz says:

    Move to a country that has a humane health care system – do it while you are young!

  8. Virginia Albin says:

    Don’t let them take your light. Stand strong. Love and good vibes sent your way

  9. Doreen says:

    I am a physician assistant. I feel that the medical industry is essentially trying to tell me to give up on my primary function in my part of this field. I was taught that PAs are supposed to be the ones who can provide education even if the MD must move on. I feel I keep getting told this isn’t really my job. I feel we are hitting a critical mass where this will have to change. I understand this student’s frustration.

    • Pamela Wible MD says:

      Exactly. To systems you are just a revenue generator. That’s it. “Health care” is an afterthought. You MUST take back your profession and align with like-minded docs who are liberated. The corp med “misery loves company” party isn’t a great way to spend one’s career.

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