The medical profession, once a noble calling made up of individuals dedicated to the challenge and responsibility of serving and caring for others while recognizing the privilege these individuals held, is now on life support in the ICU and is not expected to survive.
Medicine has been a calling since I joined the Boy Scouts of America at age eleven, where I became engrossed in studying first aid and was fascinated by the incredible machine known as the human body. For my twelfth birthday, I asked for and received a stethoscope. From that point until I received my acceptance letter from the Kansas City University of Medicine and Biosciences in Kansas City, Missouri, I prayed nightly to God for wisdom, strength, perseverance, and the opportunity to enter medical school. The path to medical school was circuitous and filled with frustration, confusion, disappointment, and ultimately elation; however, God works in mysterious ways and in His own timing.
Nearly forty-two years have passed since I started my family medicine career in Belzoni, Mississippi, and six months since I “retired.” I loved practicing medicine and always tried to do my very best. However, over these forty-two years, I have watched this noble profession—with its principal mission of providing care to the sick and injured—become little more than a job regulated by insurance companies and hospital groups. In the 1980s, 1990s, and 2000s, these groups seized the opportunity to create a huge revenue stream for themselves by expanding the medical industry “pie”, greatly restricting the physician’s share, and usurping the power of physicians who genuinely had each patient’s best interest at heart. According to those engaged and engrossed in the operations of business, physicians were seen as making too much money, having too much power, and leaving a mother lode of untapped revenue on the table because they were supposedly too “dumb” to know anything about the “business” of medicine. These business majors and newly minted MBAs could visualize and create a vast source of revenue by establishing and persuading businesses and patients that they had what everyone needed—medical insurance for everything. This approach was meant to prevent those greedy doctors from profiting excessively and “control” healthcare by keeping costs down. Well, we can all see how that turned out.
The majority of physicians didn’t enter the medical profession for the money. Most physicians saw it as a noble calling and a learned and caring profession. Independent practicing physicians were a strong patient advocate group and wielded much power. However, the insurance and hospital industry saw something different – dollar signs and control, and everything began to change.
Physicians are now primarily hospital system employees who report to these organizations’ C-suites. We have been relegated to “healthcare provider” status along with other “providers.” We lack a real voice and are merely expected to see numerous patients, bill accurately or face arrest or sanctions, meet quality measures or face discipline, and document everything in an EMR that doesn’t communicate with anyone else. In our spare time, physicians must navigate the pre-authorization process from the insurance industry for necessary tests to support each patient’s care. Naturally, the only person qualified to determine necessity is the underpaid clerk on the phone with the insurance handbook in front of them, saying, “Deny all and approve none,” while insurance companies accumulate their billions in assets and cash. Those on the “business side” would argue that these changes were essential and that the goal was to enhance patient care. I argue that it wasn’t, and it doesn’t.
Over the past forty years, the medical profession’s health has slowly taken a turn for the worse. It has been hospitalized, transferred to the ICU, and is now on life support. The future looks exceptionally dim.
I’ve attempted to speak up and do what I can; nonetheless, my small voice was drowned out by the overwhelming noise of “progress” from insurance companies, the ever-growing hospital conglomerates, and the multitude of MBAs.
I pray for a revolution where, one day, physicians will develop a backbone, rise up, reclaim their profession, and truly prioritize patients and their care. Unfortunately, I fear that the profession is too far gone; too many people, organizations, and companies have control and profit too much from the “providers,” patients, and employers for this revolution to happen. This noble profession of medicine may be lost forever. I know it won’t be saved in my lifetime, but I still pray. Each younger member of the medical profession who genuinely understands his or her calling is being summoned to the bedside of this noble field. Only a miracle can save it now; it’s probably too late, but I pray there’s still hope.
J. Lee Valentine, D.O., is a retired osteopathic family medicine physician who resides in Marion, MS, and can be contacted at jleeval23@gmail.com.