Physicians need changing courage to repair medical care after Covid-19-Forbes

During the Covid-19 pandemic, doctors showed great courage.Now you have to show the courage to change … [+] jobs.

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Long before doctors fought the coronavirus, their expert ancestors were betting their lives on the plague.

Throughout history, doctors have shown courage. In other words, the ability to act regardless of risk or fear.

Consider treating a disease such as Ebola, which cuts off a broken limb, undergoes brain surgery, or kills up to 90% of infected people. Courage alone is not enough in these dire situations. Doctors also have to deny some objective reality. You need to suppress the presence of fear, separate yourself from that emotion, not admit your weaknesses, deny pain, pay close attention to the work in front of you, and eliminate the emotions you are trying to escape.

Until recently, no one doubted whether such an extreme denial was mentally healthy. I just thought I needed a doctor.

Courage and denial remain cultural imperatives in today’s profession. These traits are taught to all medical students and incorporated into all doctors.

And they have unfortunate and tragic side effects.

I remember a talented doctor who returned to work the day after she had her final diagnosis. None of her colleagues, friends or patients knew of her illness until she died. In medical culture, this kind of emotional distance is the rule and is no exception.

As a country, we appreciate the courage and refusal of doctors. Without their courage and sacrifice over the past year and a half, Covid-19 would have killed even more of our friends and loved ones.

But now that our country has survived the worst pandemic, it’s time to tackle the shortcomings of American medical care that have damaged doctors and patients long before the coronavirus landed. Physicians need to play a leading role in both transforming the health care system and challenging their cultural assumptions.

These changes require more courage and less denial.

1. Courage to ask for help

In a recent article, I wrote about three emergency physicians who have recently experienced hell.

The resident doctor has begun a rotation in the intensive care unit where six Covid-19 patients are being treated. All died by the end of the month. Another ICU stubborn veteran said he would sweat if he woke up before dawn every day. A third senior officer saw four patients die in one day.

Psychological defense mechanisms, such as denial, help doctors reduce their fear of patient loss and avoid grief. However, like other coping mechanisms, denials are best used in moderation rather than permanent. No matter how denial, oppression, suffering, or suffering, health care workers were prepared for the mass deaths caused by Covid-19. No amount of cultural conditioning can adequately prepare for the pain that clinicians have endured. As a result, many people are tired of their work.

As the saying goes, “you can’t pour from an empty cup.” There are too many empty cups.

According to the latest Medscape doctor survey, 42% of all doctors have burnout. However, only 7% said they were looking at a therapist to improve their mental health.

It takes courage to challenge the culture of medical professionals of harsh and emotional repression. Doctors need a lot of power to recognize their limits. And it takes courage to ask for help when needed.

2. Courage to admit your prejudice

Pointing to and blaming others has become the norm in American culture. Doctors are no exception. In social media and medical conferences, doctors are rarely responsible for any of the many health care issues.

For example, consider the difference in health. If you ask your doctor why black patients have a shorter lifespan and are in poor health than whites, they will blame socio-economic factors such as income, education, and American health insurance illness. They point to social determinants (where people are born and raised, work, play and socialize) and social dynamics (segregation, poverty, educational barriers, etc.). Of course, these external factors also contribute to health inequalities, but they are not the only factors that play a role.

Studies show that two-thirds of doctors have an implicit black bias. This type of bias is different from overt hatred or conscious bias. But it’s not that harmful.

When the test kit was scarce at the beginning of the pandemic, doctors tested white patients twice as often as black patients with the same symptoms. This makes no sense, as black patients had 2-3 times higher mortality than white patients.

Bias also helps explain why black patients receive 40% less painkillers after surgery than white patients. And this helps to understand why the average black patient spends $ 1,800 less on total annual health care than a white patient with the same health problems.

For decades, doctors have argued that health inequality is due to other parties in American society, existing policies, or the healthcare system. We need to address these barriers to improve the health of all people, but doctors must also show the courage to raise the mirror to the profession. After all, it is they who decide which patients to test and how much painkillers to administer.

Until doctors have the courage to face their prejudices, they will continue to break the sacred vow of medicine to “do no harm first.”

3. The courage to treat the patient like a health partner

Entering the 21st century, the Internet has closed the gap between professionals and others. In today’s health care, patients can explore illnesses and treatments more deeply than ever before.

Many doctors consider excluding health information from the Internet to be a “bad drug” prescription. may be. However, doctors cannot expect patients to stop looking for evidence on the Internet. People did not suddenly demand information, transparency, and convenience from medical and other services.

American consumer culture never disappears. As a result, more and more Americans are seeking a new type of relationship between doctors and patients. It’s more like a partnership than a paternity. This partnership needs to take into account the needs and wishes of the patient.

Telemedicine is a good place to start. Only 8% of Americans had a “virtual visit” to a doctor before the pandemic. Most doctors insisted that good doctors could only be treated in person. Covid-19 proved that this perception was wrong. A recent study found that 20% of consumers (55 million Americans) would replace their doctors with those who provide telemedicine.

Historically, physicians have not prioritized or prioritized patient time, convenience, or preferences. In the future, they have no choice. A more equal physician-patient partnership requires the courage to embrace an alternative approach to treatment and to embrace that the patient has become (and will continue to be) a savvy healthcare consumer.

4. Courage to pursue the true mission and purpose of medicine

For most of the medical history, the illness has plagued doctors. The plague comforted the sick and killed millions, including dying doctors. With a doctor in a sick bed, the entire civilization died miserably. Still, doctors did not lose their nerves or their desire to help.

Today, many doctors feel like victims of a broken system. They blame professional dissatisfaction with commercial insurance companies, greedy pharmaceutical company executives, and hospital managers. And while it’s right for them to seek radical health reforms that free them from the administrative distractions that prevent them from doing their jobs, they also show the courage to change what they can control. Must be.

Doctors are the people who make prescriptions that contribute to the deaths of 60,000 opioids each year. They have signed an astonishing medical bill that has bankrupted millions of patients and their families. They contribute to preventable malpractice, which kills 200,000 people each year. They perform 30% of all procedures that Mayo Clinic researchers have shown to have no clinical value.

American doctors are at a crossroads. You are part of a wonderfully beautiful profession that is currently at stake. Physicians must continue to adhere to the correct mission and purpose of medical culture. At the same time, they must have the courage to develop the most problematic parts of the culture. Not only does this benefit the patient, but it also restores a professional reputation.

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