DR-Exit: Sean MacStiofain said “most revolutions are caused… by the stupidity and brutality of governments.” Regulation without legitimacy, predictability and fairness always leads to backlash instead of compliance. If something is not done to stop MACRA implementation, more physicians will opt-out of Medicare and Medicaid than is fathomable. Once DRexit begins, there will be no turning back.
Imagine what quality metrics the pediatric cardiac surgeon is going to track. He would do well to collect statistics on how often he images patients for appendicitis because it is likely a rare occurrence. Things are really looking up for the use of data and technology in healthcare. Costs are likely to keep rising with everyone scoring in the 99th% percentile once they figure out how to game the system. But we certainly cannot stand in the way of science or progress now can we?
Among female physicians, the relative risk of suicide is 2.3 times greater than the general female population. Each and every tragic loss of a female colleague should be honored as if we lost a part of ourselves. Their struggles must become ours; their survival is imperative for us all. If you are struggling, please know, we are here, we are listening, and we care.
I need a light, a stethoscope, and a pen to heal and comfort human beings; the rest is basically nonessential. This Mexican physician and I fundamentally do the same thing every day; except he has no receptionist, no billing personnel, no manager, no administrator, no care coordinator, and definitely NO EMR in his emergency clinic. He documented the visit in less than 3 minutes (like I do), signed it, and handed me the top page for my records. His care was good, his skills were solid, and his decision-making sound; I would have treated any other child the same way.
As physicians, we do our best to set patients up for successful futures. This instruction can begin when a person is a few days old and may continue for a lifetime. In primary care, we observe children grow into adults, finish their educations, and embark on families of their very own. The single greatest aspect of medicine for me has been to realize the impact our lasting relationships can have; something that was facilitated by being a female physician.