About a decade ago, a doctor friend was lamenting the increasingly frustrating conditions of clinical practice.
“How did you know to get out of medicine in 1978?” he asked with a smile.
“I didn’t,” I replied. “I had no idea what was coming. I just felt I’d chosen the wrong vocation.”
I was reminded of this exchange upon receiving my med-school class’ 40th-reunion report and reading some of the entries. In general, my classmates felt fulfilled by family, friends and the considerable achievements of their professional lives. But there was an undercurrent of deep disappointment, almost demoralization, with what medical practice had become.
The complaint was not financial but vocational—an incessant interference with their work, a deep erosion of their autonomy and authority, a transformation from physician to “provider.”
As one of them wrote, “My colleagues who have already left practice all say they still love patient care, being a doctor. They just couldn’t stand everything else.”
By which he meant “a never-ending attack on the profession from government, insurance companies, and lawyers … progressively intrusive and usually unproductive rules and regulations,” topped by an electronic health records (EHR) mandate that produces nothing more than “billing and legal documents”—and degraded medicine.