There are difficult issues confronting physicians generally, regardless of whether they are primary care physicians or specialists or employed or in private practice. The list is long and growing as more and more requirements, costs, mandates, and regulations are being inflicted in an environment of decreasing compensation. All of these lend to the rapidly lost freedom and autonomy for a medical profession where these are foundational.
It seems clear that the issues addressed are related to the system and not the essence of the profession’s mission, providing health care to those in need in a trusting relationship between patients and their physicians. It is appropriate to conclude that the intermediaries, increasingly inserted into the care process, are the major sources of frustration. Health insurance companies, government programs, and other agencies add regulations, mandates, and required technology to the system at will. Reasons are defined as beneficial to patients, but the reality is different. This is quite simply “virtue signaling” to obscure other motives. All of this hampers physician productivity. Said differently, it subtracts from the direct care and personal interaction with patients as well as adds costs to the business of providing care in an environment of frozen or decreasing compensation. It seems peculiar that physicians sign onto the regulatory morass they complain about. All of this is “voluntarily” agreed to in contractual obligations accepted by physicians.