If you are a physician who has been in a leadership position any time over the last 20 years then chances are you have contributed significantly, with acts of commission or acts of omission, to the current problems in health care and the profession of medicine. Not all of you but most of you. Maybe not all of the time but most of the time.
There is no plausible denial. No pointing fingers in another direction. Look in the mirror. It’s about personal responsibility. You helped to get health care where it is today. And that’s not a good place. Physicians in leadership positions should have been leading the charge of advocacy. Advocating for patients. Advocating for physicians and the practice of medicine. It hasn’t happened. In fact, rather than resisting the pressures that have created the current corporate model of medicine an argument could be made that physicians in leadership positions have in fact allowed themselves to be used as tools to take health care where it is today.
Some, if not most, of the guilty physician leaders have had a pedestrian existence with just local toxic influence. However, others have had positions of national prestige. Icons within their respective fields. Department Chairman and leaders of national organizations and societies. In both scenarios the position of leadership was more often used for self-serving purposes rather than strengthening the profession. While young physicians were looking for mentors, advisers and advocates they instead were left with physician leaders beating them on the nose with rolled-up newspapers like bad puppies. While patients were looking for a strong presence to defend their interests they instead were left to deal with the forces of corporate medicine alone.
Is there an explanation for why physician leaders have historically forsaken patients and the profession? Was a leadership position simply an easier path? Did leadership provide better compensation? Ego? Maybe they entered the position with good intentions and then realized they lacked the courage, fortitude and know-how to fight the good fight. The reason is irrelevant. The bottom line is that they were in a position to make a difference and they did nothing to help the cause of patients and their doctors. Hopefully future physician leaders will realize the importance of their position. Their obligations lie first and foremost in preserving health care as defined as the exchange of services from a professional to a person in need. Although a corporate entity may sign the paycheck they
Physician leaders of the past 20 years get to claim today’s health care system as their legacy. They haven’t provided a solution so that means they have been part of the problem. It’s what they helped create.