To Put It Bluntly: Doctor's Don't Care About You Anymore

[Obama 2012 1,714]

While the title I wrote is a bit stretching in describing all of today's doctors, it does make a point that we have changed in the way doctors view their patients.

The disconnect is there in a lot of cases these days and it's really a shame.

Don't get me wrong, doctor's need thier personal time too, we all do. It just seems like an industry that was once about the patient, isn't so much anymore on all levels.

Corporate + Doctor does not = care in my book.

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http://www.nytimes.com/2011/04/02/health/02resident.html

HONESDALE, Pa. — Even as a girl, Dr. Kate Dewar seemed destined to inherit the small-town medical practice of her grandfather and father. At 4, she could explain how to insert a pulmonary catheter. At 12, she could suture a gash. And when she entered medical school, she and her father talked eagerly about practicing together.

But when she finishes residency this summer, Dr. Dewar, 31, will not be going home. Instead, she will take a job as a salaried emergency room doctor at a hospital in Elmira, N.Y., two hours away. An important reason is that she prefers the fast pace and interesting puzzles of emergency medicine, but another reason is that on Feb. 7 she gave birth to twins, and she cannot imagine raising them while working as hard as her father did.

“My father tried really hard to get home, but work always got in the way,” Dr. Dewar said. “Even on Christmas morning, we would have to wait to open our presents until Dad was done rounding at the hospital.”

Dr. Dewar’s change of heart demonstrates the significant changes in American medicine that are transforming the way patients get care.

For decades, medicine has been dominated by fiercely independent doctors who owned their practices, worked night and day, had comfortable incomes and rarely saw their families.

But with two babies, Dr. Dewar wants a life different from her father’s and grandfather’s. So instead of being an entrepreneur, she will become an employee of a large corporation working 36 hours a week — half the hours her father and grandfather worked.

Indeed, emergency room and critical-care doctors work fewer hours than any other specialty, according to a 2008 report from the federal Department of Health and Human Services.

Her decision is part of a sweeping cultural overhaul of medicine’s traditional ethos that along with wrenching changes in its economics is transforming the profession. Like Dr. Dewar, many other young doctors are taking salaried jobs, working fewer hours, often going part time and even choosing specialties based on family reasons. The beepers and cellphones that once leashed doctors to their patients and practices on nights, weekends and holidays are being abandoned. Metaphorically, medicine has gone from being an individual to a team sport.

For doctors, the changes mean more control of their personal lives but less of their professional ones; for patients, care that is less personal but, as studies have shown, more proficient.

Older doctors view these changes with considerable ambivalence, among them Dr. Dewar’s 90-year-old grandfather and 61-year-old father, although both supported Dr. Kate Dewar’s decisions and were thrilled about the birth of her twins.

“My son and I had deeper feelings for our patients than I think Kate will ever have,” Dr. William Dewar II said over lunch at a diner in Honesdale, about 30 miles northeast of Scranton. Munching on a club sandwich, Dr. William Dewar III gestured toward the diner’s owner, who had greeted them deferentially.

“I’ve had three generations of his family under my care,” he said as a waitress brought his usual Diet Coke without being asked. “Kate will never have that.”

In a separate interview, Dr. Kate Dewar said that treating chronic conditions like diabetes and high cholesterol — a huge part of her father’s daily life — was not that interesting. She likened primary care to the movie “Groundhog Day,” in which the same boring problems recur endlessly. Needing constant stimulus — she e-mails while watching TV — she realized she could not practice the medicine of her forebears.

“I like it when people get better, but I’d rather it happen right in front of my eyes and not years later,” she said. “I like to fix stuff and then move on.”

Her attitude is part of a gradual distancing between doctors and patients. Doctors were once revered, but a host of intermediaries — insurers, lawyers, the Internet, growing patient needs and expectations — have intervened, to the point that many patients now see doctors as interchangeable. Younger doctors are deciding that the personal price of being at their patients’ beck and call is too high, while acknowledging that teams of doctors can offer a higher quality of care. So they are embracing corporate, less entrepreneurial and less intimate roles in part for the uninterrupted family time they bring.

continued..... http://www.nytimes.com/2011/04/02/health/02resident.html