PRESIDENT'S MESSAGE
Recently, a patient emailed me at 2 a.m. about a non-life-threatening concern, then proceeded to call the office at 8 a.m. to complain that their email had not been addressed. The patient had an upset tone, demanding an explanation as to why their message wasn’t addressed within six hours while the office was closed. The patient was then offered a same-day appointment with me, but continued to voice their displeasure and said they planned to place a formal complaint with a patient advocate from their health plan.
This experience with the patient was incredibly frustrating. My patient had unrealistic expectations regarding 24/7 personal access to me and a means to express that dissatisfaction when those expectations were unmet. Sadly, this is not the first time I have had an experience like this, and, unfortunately, is it unlikely to be the last unless something changes.
As you’ll read elsewhere in this issue, physicians are under more threats and pressures than ever. Between constant reminders from health systems that we have to maintain “productivity” (more patients on our schedules or panels and less time with each one) and the expectation that a busy doctor must do everything in their power to please and accommodate patients — we desperately need a reset.
A recent University of Chicago study found that if a primary care clinician followed national recommendation guidelines for preventive care, chronic disease care and acute care, it would take 26.7 hours per day to see an average number of patients and complete the tasks at hand. The study also found that this time pressure was a major reason why improved outcomes haven’t kept pace with medical advances.
Patient expectations have grown to the point that they expect us to respond more like customer service, not as physicians who are often coordinating multiple elements of care. Today, it is not uncommon for a physician to receive an angry email with capitalized words for emphasis from a patient who is unhappy about an unmet demand. We have experienced patients who call and shout at our teams or make an appointment to shout at us in person.
Unfortunately, we are also aware of fatal acts of violence towards physicians like Dr. Benjamin Mauck, a hand surgeon in Collierville, Tennessee. On Tuesday, July 11, 2023, Dr. Mauck went into the exam room to evaluate a patient and was shot and killed by his patient. I send my condolences to the Mauck family, medical team, and community. Acts of violence towards physicians are now realities for all of us.
We don’t deserve any of that. With the excessive demands, we’re seeing frightening rates of burnout and early retirement. We work incredibly hard. We sacrifice so much time away from our families, our kids, our partners, our friends and ourselves.
Mistreatment happens when patient expectations, as unrealistic as they may be, are not met. It’s exacerbated when health systems, hospitals and medical groups push to earn high patient satisfaction survey scores at the expense of physicians and quality of care.
An epidemic of irrationality and entitlement is sweeping the nation, and we aren’t armed with a pill or procedure that will fix it. During my presidency, SSVMS is increasingly focused on how to protect physicians from external threats such as patient violence and internal threats that include policies that push physicians beyond their limits.
As physicians, we need to stand strong together and fight for ourselves and our patients. We have leverage: Years of experience and caring relationships with patients need to be in the forefront. We’re all in this together, and I do believe there is a shared goal of better outcomes for patients. I don’t have all the answers, but I know two things: SSVMS and CMA are going to continue to advocate to protect physicians from physical and financial threats, and that if we’re going to fix our fragile health care system it’s going to take bringing everyone to the table. We’re all in this together and if we truly care about the same things — giving doctors an encouraging atmosphere where we can use our talents, protecting us from harm from patients and mistreatment by administration and health systems, maintaining a reasonable work-life balance, and, most importantly, ensuring better patient outcomes and addressing health equity — then we better sit down and find some real answers now.
