If you are an avid reader of our newsletter or blogs, you know that we focus on payment integrity, program integrity, fraud waste and abuse, and the cost/quality of healthcare. We are often talking about the business behind healthcare, and not necessarily the doctors and their mental health. Being in this business for as long as I have, I tend to come in contact with doctors who are committing some type of fraud, waste or abuse.
Yesterday in a training, one of my directors said to a group of special investigators at an insurance company, every day you go to work and your job is to ruin someone else’s. Putting that aside, I do believe and hope that most providers are deeply committed to the medical profession, and that the ones that we have the “opportunity” to work with, are the outliers. This article by the New York Times outlines some of the issues doctors face when they are burned out from working too hard because the healthcare system makes it difficult for them to care for their patients.
We often hear that the documentation requirements leave providers with less time to talk to their patients. We have also heard from providers who ended up committing fraud talk about how expensive it was to do their job, and that they were being unfairly compensated.
“More and more doctors are coming to believe that the pandemic merely worsened the strain on a health care system that was already failing because it prioritizes profits over patient care.”
Doctors on the front lines of America’s profit-driven healthcare system are susceptible to moral injury, which is a term used to describe the emotional wounds sustained by doctors when they witness or commit acts that violate their core values during the course of fulfilling their duties.
Psychiatrist Wendy Dean and surgeon Simon Talbot published a piece about their experience succumbing to this strain, “as the demands of administrators, hospital executives and insurers forced them to stray from the ethical principles that were supposed to govern their profession. The pull of these forces left many doctors anguished and distraught, caught between the Hippocratic oath and ‘the realities of making a profit from people at their sickest and most vulnerable.’”
However, as this article so poignantly outlines, doctors do not necessarily have a safe way to report issues with the system and/or their own mental health struggles because, more than likely, there would be a negative impact to their career.
As private equity investment in the healthcare industry has surged, increased merger and acquisition activity has forced physician practices, hospitals, outpatient clinics, and home health agencies to do business differently. “Once in charge, these companies start squeezing the doctors to see more patients per hour, cutting staff.”
As the focus on revenue and the adoption of business metrics has grown, I wonder if we will see more fraud, waste and abuse, higher physician suicide rates due to their moral injuries, or perhaps less people embarking on careers in medicine.
by Jeanmarie Loria, CEO at Advize
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