Here We Go Again: Physician (and Nursing) Stress - What That Means For You and Me

By Dr Lloyd Sederer

When Covid-19 was last raging – and in the years after – doctors were fleeing direct patient care. As were nurses. Difficulty getting an appointment with a doctor were affecting patients and families across this country. Doctors were leaving direct patient care (as were nurses) not only because of fears that they would make their families ill with Covid but also because of their suffering from burnout and “moral injury” (being forced to practice in ways they believed compromised their medical and moral standards).

Covid now again is darkening the medical landscape. In the past, this meant doctors (and nurses) fleeing direct patient care, worsening doctor (and nurse) shortages, evident when you are seeking an appointment. And will, once again, today produce the same difficulties getting a needed appointment for you and your family members.

Covid aggravates the plight of direct care medical professionals whose practices have been hijacked by for-profit medical care. Corporate controlled medicine places profits before medical care. It controls doctors’ professional lives on the basis of financial spreadsheets, rather than needed medical care. As a result, not only Covid, but also corporate owned and controlled medicine is driving doctors (and nurses) away from the patient care you and your families need.

The two main reasons healthcare professionals flee patient care are burnout and “moral injury”.

Burnout is the result of the corporate control that overwhelms doctors with high patient care loads, typically associated with shorter visits and the reduction in needed support services. Both meant to reduce costs – read increase profits.

“Moral Injury” is when health professionals believe they are providing care below their standards for needed and good care. Quality care is anathema to the greed of corporate, for-practice medicine. Profits before patients is the standard of corporate medicine, and it is getting worse as more and more of medical care is owned and managed by huge, for-profit medical care chains (like Hospital Corporation of America - HCA) and mega-for-profit healthcare insurers, like Aetna, Humana, Emblem (formerly BC/BS), and HCA. Doctors working in corporate controlled medical care environments know they are compromising their own professional standards. That’s the recipe for moral injury, where professionals know they are delivering sub-standard care because of the demands of their corporate ownership.

American medicine is being raped by its for-profit owners. Doctors (nurses too) are working on a corporate conveyor belt with more patients, less time to see each one, poorer administrative and clinical resources to meet the demands ownership creates, and being slavishly held to the burdens of Electronic Medical Records (EMRs) whose principal purpose Is to bill visits to maximize corporate profits, not to maximize quality patient care. Surveys indicate EMRs produce 2 hours of “paperwork” for every hour of direct patient care. 

More and more doctors spend time away from their families in the evenings to complete filling in EMRs. EMRs are not designed to improve care but to maximize profits for the practice’s corporate owners. The US Department of Justice (DOJ) is rife with insurer cases of fraudulent billing (especially by Medicare Advantage Plans) because of corporate control over practices billing, known for fraudulently over-billing Medicare for tens of billions of dollars every year (that’s your tax dollars and mine).

US Healthcare is now predominantly owned or managed by for-profit large insurer owned practices and mega-for-profit health insurers (Humana, Emblem, Aetna, HCA). No wonder doctors are fleeing for-profit clinical care, which demands they meet this next wave of Covid at standards of care they know compromises their medical morals (moral injury).

We are all feeling the corporate rape of American Healthcare: Patients, families, employers, doctors, nurses, and other health care professionals. While that rape has metastasized widely it has not become fatal. It is in all our hands, as individuals and collectively, to demand the quality medical care due us. That means being a vocal advocate for your services and those dear to you. Don’t be timid about the care you and loved ones are due. Your being vocal for what is good and needed will help health care professionals hold the line they know is needed when being pressured to go to the ‘dark side’.

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Lloyd I Sederer MD is a psychiatrist, public health doctor, and non-fiction writer.

You can sign up for his blogs and contact him through his website: www.askdrlloyd.com

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