Thursday, January 19, 2006
My bags were packed and I purchased my exit ticket when it occurred to me that I still did not have a good reason for leaving. It has been almost fifteen years since I graduated from medical school. I was feeling like many of my colleagues in medicine and said that I had enough and wasn't going to take it anymore. I closed my office, said goodbye to my friends at the hospital where I practiced and paid the tail on my medical liability (malpractice) insurance. (The total exit fee was around eighty thousand dollars which is about what it cost me to get into medicine.) My reasons for leaving were numerous and sounded like those I listened to for years in the doctor's lounge. I began writing which was amazingly therapeutic. Much of what I wrote about were justifications for why I was leaving. Decreasing reimbursements. Rising costs, especially medical liability insurance. Litigious patients. Greedy lawyers. Manipulative insurance companies. Hospital administrators that really didn't understand patient care and were only concerned with the bottom line. Corrupt politicians who for years turned their backs on the growing problems. Incompetent physicians and medical societies that lack the good sense to know when to function like a team and circle the wagons when they are under attack and in the fight of their life. You name it, I found a reason to point the finger and blame and there was plenty to go around. I came to the initial conclusion that the whole United States health care system was quickly going down the toilet. I thought, "Good. Flush twice because these endotoxic swine need to be pushed far out to sea." Ok, I was a little bitter and slightly burnt around the edges. I wrote like this for months and then one day the writing changed and I realized that so had I. After mentally purging myself I began to see something different happening in our health care system. I don't have a crystal ball but I noticed an emerging pattern which I believe explains what this process is. Our health care system is not dying. Far from it. It is being reborn. There is an emerging paradigm happening before our eyes that will eventually replace the currently established paradigm. I began writing feverishly in my journal and thought I would share this publicly. It is what this blog is about. There is a crisis in our health care system but it is a transforming crisis. Things are going to get ugly for awhile but when it's over it will be better and stronger as a result. There will still be problems and there will still be challenges but I truly believe it will better and stronger. I also believe it will fundamentally appear radically different then what it looks like today. So I have unpacked my bags and put the ticket on hold. I'm going to stick around a little longer to see how it shakes out in the coming years.