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A hope note

My favorite physician, who began his medical practice almost half a century ago, wrote me recently about changes in medicine that disturb him.
He reflected on how, in 1960, he began the day in the doctors’ lounge, sitting around a table and talking with about a dozen physicians about nothing specific, just laughing and joking and feeling their camaraderie in a great and noble cause.
He mourns the change in medicine over the past few decades to ‘an industry with profit first and patient care second.’ He says the change is epitomized in the demeanor of doctors walking down the halls early in the morning. Most of them he meets are looking down at the floor ahead. ‘No one seems happy.’ When he smiles and says hello, their responses vary ‘between a greeting, no response or a ‘hunpf’ or something I could not understand.’
He speculates that the non-responders may be wondering how they will manage to get through the maze of restrictions on medical practice that day, or how to avoid malpractice, or how to get approval for a procedure a patient definitely needs but may be subjected to some loophole that disallows it. Whatever is going on, there is ‘no apparent joy or anticipation of the coming day.’
He notices how doctors’ lounges have changed. Hospitals now provide a sumptuous breakfast that pulls physicians in from 7 to 9 a.m., but there’s little conversation going on. Physicians are eating or reading the sports page or The Wall Street Journal.
My favorite physician is hopeful. He insists that, because of almost-daily escalating costs, government will have to step in and force some dramatic changes in the next 10 years. Then physicians may get back to the reason they chose the practice of medicine: to heal the sick and injured.

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