When doctors at Sacred Heart Hospital in Oregon heard that the hospital would be outsourcing their hospitalist care to an outside company (rehiring the existing hospitalists), many were not happy, to say the least. They expected that they'd be pushed to see more patients per day -- and were not willing to make that change without a fight.
Eventually, some of the hospitalists left for other jobs -- and the rest formed what became the first single-speciality doctor's union in the country.
We really identified with one line from the recent New York Times article about the unionization: "you get the distinct feeling it is not just their jobs that hang in the balance, but the loss of something much less tangible — the ability of doctors everywhere to exercise their professional judgment."
One big driver of Sacred Heart's push with the hospitalists was that the hospitalists be forced to have some "skin in the game" -- their way of referring to performance-based incentives. One of the hospitalists, Dr. Schwarz, really bristled at this concept. “It really took all of my self-control to not say, ‘What the hell do you mean skin in the game?’” he said. “We have our licenses, our livelihoods, our professions. Every single time we walk up to a patient, everything is on the line.”
As decisions become more centralized, as administrators and doctors take up opposite sides of the table, and as the pressure to cut costs, slash readmissions and length of stay, and increase profits and medicine increase at every turn -- yes, the hospital begins to ressemble a factory. And it's not any one person's fault. It's a system that has so much pressure on every aspect of it that it is hard to retain dignity and humanity in the day to day.
What are the consequences? Well, provider burnout for one. As the American Medical Association found not too long ago, the main pieces of medical providers avoiding burnout are enough one-on-one time with patients, and the sense that they've provided good care. This fits with what is being found in other industries about the need for people having autonomy, mastery, and purpose in their work.
As Dr. Brittany Ellison put it: “We’re trained to be leaders, but they treat us like assembly line workers,”
So what is any individual provider to do?
We think you do what you can, with the hospital, doctors, and administration you have. Administrators and doctors are both doing the best they can, with the constraints they have -- we all would do well to focus on what we can do for the patient in front of us.
iClickCare saves hospital systems money. It improves care. But beyond all of that, it also puts the power of treating patents back in the hands of doctors. Sometimes a whole hospital system comes to us and decides that they want to use telemedicine to meet their goals. Sometimes, though, it is a single doctor who starts using iClickCare for medical collaboration with their colleagues.
That's the beauty of this kind of simple telemedicine -- you don't need everyone to do it, in order for one person to do it.
You can do a great job, for this patient, right here and now.
You don't have to wait for permission or incentives to do medical collaboration with telemedicine. You can try iClickCare today, on your own smartphone, for free: