The article begins bluntly by noting that 9 out of 10 doctors will discourage others from entering the profession, and that on average, one doctor commits suicide every day. Citing another study, the article claims that physicians have the second highest rate of suicide among all professions, trailing only marine engineers.

Those numbers are chilling, but they are only surface-level statistics. By digging a little deeper, we can find out why doctors are so depressed.

The article goes on to cite three main factors that make a doctor’s life miserable, and not surprisingly, I mentioned all three in my Q&A session with MedPage Today. They are:

• Bureaucratic red tape.

• More patients than ever before.

• Unappreciative patients.

Off the first point, the article notes that processing insurance forms costs doctors $58 for every patient they encounter. The time and money spent on insurance regulations alone has led many health professionals to jump to management or supervisory positions, which in turn leads to the second point.

An increasing number of people are entering the healthcare system without an equal number of doctors entering the equation. This leads to doctors taking on more patients than ever before, which means they’ll spend less time with each individual. The article notes that the average face-to-face clinic visit last about 12 minutes.

Again, this leads to the third problem – the unappreciative patient. Sometimes the best advice is rest, but patients want a miracle cure for their ailments. When an operation is available, it can be costly, and that can leave patients feeling dejected. But we try to work with patients. We provide care at essentially a sliding scale based on ability to pay, not on complexity of care delivered. We discount our bills routinely to help out others unable to make payments and set up payment plans that would make an accountant cry.

Every month, I am presented with a list of patients by my office management and the same line, “We have attempted to contact these patients multiple times and they haven’t responded to our calls or letters. They are 6-, 9-, 12-months past due on their bills. Can we send them to collections?”

These people that I know, that I have spent time building relationships with in order to be able to deliver the best care, now think that little of me and my office that they won’t answer a letter or return a phone call? How would that make people in other businesses feel?

All of this care and work is completely unseen and unacknowledged by the public. The media gives us stories about the doctors that made the most money last year through Medicare, not the doctors that donate the most time and energy.

Is it disheartening? Yes.

Am I surprised about the number of doctors jumping into Administration or into Finance? Nope. Money attracts a lot of smart people.

Am I surprised by the number of doctors committing suicide? Yes, because as bad as it gets, I still get a boost every time I hear, “Thank you Dr. Silverman,” or “I tell all my friends and anyone I meet that they must come and see you.” I hope other doctors hear that too.

Is the medical landscape getting worse? Sadly, yes. But I ask doctors, medical students and patients to remember this sentiment:

Doctors do more good every day then most people do in a year.

We listen to people. We to get to know them. We listen patiently to their stories and the way they communicate in order to build relationships and to understand how to best provide our health care recommendations. We literally put people, both physically and mentally, back together. Remember the rewards this job offers the next time you feel down. Know in your heart you are making a difference.

Related source: The Daily Beast

The post The Sad State of the Medical Landscape in 2014 appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

Authors of the survey said noncompliant patients were by far the biggest gripe amongst doctors and primary care physicians, as defiance made it harder for doctors to provide the best care possible.

“Most of the doctors we surveyed said it affected their ability to provide optimal care,” the authors said. “Thirty-seven percent said it did, so ‘a lot’.”

Pattern of Disobedience

Results of the survey as well as accompanying patient data suggest that noncompliance is one of the largest problems in the healthcare community. Some of the related findings reveal:

• A survey of 1,000 patients found that nearly 75 percent admitted to not always following medication guidelines as recommended.

• Almost four billion prescriptions are written each year, yet more than half of them are taken incorrectly or not at all.

• A study of 75,000 insured patients found that 30 percent failed to fill a new prescription.

• Prescriptions for high blood pressure, diabetes and high cholesterol went unfilled about 20 percent of the time.

• Only about 50 percent of chronically ill patients take their prescriptions as recommended.

• Noncompliance or improper compliance accounts for 33 to 69 percent of adverse health events that result in hospital admission.

• In a study of over 240,000 patients who were prescribed an antidepressant, less than 30 percent were still taking the medication six months later.

• Patients with hypertension who don’t follow their medication recommendations are 5.4 times more likely to be hospitalized than those who follow the directions.

The findings point to a disturbing trend with great costs and deadly consequences. The US healthcare system estimates that poor compliance costs the industry $290 billion dollars and accounts for more than 125,000 deaths in the United States each year.

Dr. Silverman comments

You can lead a horse to water, but you can’t make him drink. You can prescribe hypertension medication to a person with high blood pressure, but you can’t put the pill in their mouth.

The scope of noncompliance shouldn’t be limited to medication, but to all advice provided by a doctors. Few things frustrate me more than when I tell a patient to get 30 minutes of moderate exercise a day, and I meet with them weeks later to find out that they aren’t doing the work.

My primary concern is a patient’s health, so it bothers me when their actions suggest it isn’t also their top concern. Healthcare needs to be a two-pronged approach. At the end of the day, I can preform an operation or prescribe medication, but I can’t follow you around 24-7 to make sure you follow the recommendations. I can’t wave a magic wand and make you get better. Every single case involves some post-op action by the patient, and noncompliance is the quickest way to end up back in the hospital.

Related source: Medscape

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