Tunnelvision
As the transcriptionist is the little guy who seems to be the first target in a hospital’s budget crunch or in an MTSO’s grasp for even greater profits, it’s hard not to get rather myopic and feel like THE target these days. Every once in a while, though, I get a reminder that it’s not just MTs who are facing big, bad changes these days. Case in point is my monthly fix from Placebo Journal, which is pretty much where good doctors go to get snarky about the state of medicine from their perspective, vent some frustrations, get silly, and I assume manage to stay sane another month. Now, transcribing four dozen reports or so a night, you get a good feeling for what they have to put up with. Yes, there's always a handful of docs who give you the feeling they’re a few years overdue for retirement, but the vast majority sound like they care.
At least, they must or they wouldn’t be able to muster such a dispassionate tone when so many of their patients seem to be noncompliant frequent flyers, and the vast majority are in the hospital almost assuredly because they refuse to do as they’re told. I'm not sure I'd have the patience to calmly repeat 20 times a day, “Quit drinking. Quit smoking. Lose weight. Take your medicines as prescribed. Use a condom. Don’t put things in there.” You just know that drunk is going to be back in two weeks needing a belly tap, the diabetic is going to lose a foot, the woman with asthma is going to be back on the ventilator because she won’t give up her cigs, and 20 people are going to trail in for pregnancy tests or penicillin in any given night because they’re just idjuts. That doctors can even have a sense of humor is amazing. I suppose that’s where the last guy comes in--the one who seems to have a knack for sleepwalking, slipping, and landing just so, so that assorted household items miraculously lodge themselves in his colon. . . every couple months.
Yeah, it’s a little hard to sympathize, knowing they make 1000 times more than we do, but consider how they earn it. Being a doctor is not about Medicine anymore. It’s about business. It’s about squeezing in 20 patients a day to keep your practice afloat. It’s about battling insurance companies to get services paid for in this lifetime (if at all). It’s about cookbook medicine--following strict protocols for every condition so that your hospital will be less likely to be sued when someone dies. It’s about Big Pharma controlling the drug supply (did you know they’re now trying to get OTC nutritional supplements outlawed so they can market them as brand items?) and their pushy pharmaceutical sales reps--which, thanks to the miracle of television, now includes thousands of gullible patients, eager to do the job for them for free.
You just know that most patients don’t get it. The proof of this lies in the response to a recent Reader’s Digest article, 41 Secrets Your Doctor Would Never Share, wherein two dozen doctors honestly shared their frustrations, regrets, disenchantment, and advice on how to be a better patient--and far from being grateful for the eye opener, many readers responded in a huff. It’s a shame, because there’s a lot of wisdom behind the statements shared.
In the old days, I resented the pedestal most doctors seemed to place themselves on, as though they were the wise, fatherly figures and we were children who should simply do as we were told, without question. Whilst I think it’s great that we now have a world of information at our fingertips and can now have a more educated say in our medical treatment, I think we’ve lost something important in the process. The masses are deciding that those years of study and hard work don’t count for much. Insurance companies are trying to dictate treatment. New technology means you have to churn more patients through, even though you don’t have time enough for meaningful interactions as it is. Malpractice involves more greed than legitimate complaints. I think there’s a good reason doctors commit suicide, nurture addictions, and probably divorce in far greater numbers than the general public. MTs certainly have earned the lifetime Rodney Dangerfield “I don’t get no respect” Award (acknowledging that there's a passel of clerks, coders, billers, and even nurses as close runners-up), but I don’t see the practice of medicine maintaining its appeal as a career choice, either, given that do-gooders are beaten down by the system and the guys in it just for the money would have an easier time becoming lawyers.
Of course, my sympathy will fly out the window next time Dr. Jones forces me to sit idly (I don’t make money if I’m not typing!) whilst he’s on another line for 20 minutes trying to cajole a salesman into giving a discount on his new Cessna, or Dr. Brown zips another young mother off for his routine, time-saving C-section. It is a good exercise to remove my blinders once in a while and think beyond myself, though--and in looking even further out there, I get the feeling that our problems aren’t even unique to the world of medicine. The business climate these days has generated a lot of negativity across social strata, and I think things are going to get worse before something revolutionary happens to change it.
So I don’t end on such a dismal note, I will veer off to my happy spot, wherein I finally meshed with my proctor and completed my Computers in Healthcare final last weekend. I’m in no way happy with the substance of the course (filler, fluff, and material cancer registry students couldn’t even access--yet were tested on), but it’s one more prerequisite behind me. I am once more gleefully cracking open a new text with fresh highlighters and enthusiasm, in the hopes that Medical Terminology gets me back on track. I work with these words every day--surely, this will be an easier credit, right?
Next time: Famous Last Words.