Thank you for the gift link!
I agree with almost all the points made in the article. The only area where I think the author was a bit off mark was when he attributed doctors’ dislike of the new management practices to resentment over loss of prestige (e.g. that weird quote about “platinum-level social status at high school reunions and Thanksgiving dinners.”)
I do not give a crap about prestige. My former high school classmates generally don’t know I’m a doctor, and anybody at my Thanksgiving table doesn’t care (they know that I put on my pants one leg at a time.) And I formerly worked in retail and food service so I don’t think I’m “better” than workers in those industries as the author seems to imply.
What I DO think is different about my job is how extremely close the relationship we doctors have with patients (i.e. the people that our management calls customers): I have heard their worst secrets. I have seen their crotches. I hand them kleenex when they cry. (I sometimes cry myself.) I tell them when they are dying. I hold their hand when they are dying. I hand their spouses kleenex after the fact, and attend their funerals if it happens to fall on one of my days off.
So when management (usually some 29 year old dude with a recent MS in “Healthcare Management” from the local evening class diploma mill) tells me I would be more “efficient” by double booking more of my slots, yeah it pisses me off.
100% agree about the weird comment about prestige.
Feels like the writer had a conclusion about how physicians feel but not any evidence to back that part up.
Physicians I know aren’t worried about being the “big dog” at their high school reunion. They are more concerned about doing a good job and having the time and resources to do so.
Very true. My brother retired last month after 35 years in the ER because of the exploding gov’t imposed paperwork demands accompanied by less staff support in the ER (in the name of efficiency?!) that causes insane wait times for patients (now averaging 52 hours across Montreal) that threaten patient health and actual survival. Nurses are unionized and are currently taking strike action for better working conditions (the government banned vacations for nurses for 2 years during COVID, and many left the profession due to burnout so those left are feeling the brunt). The government has tabled a bill to centralize the control of all hospitals, giving them the power to send nurses to any hospital or service they choose (total disrespect to specialization required in different services like NICU, OR, transplants etc.). It’s just a brutal time to be in medicine. My brother retired early because he is afraid that with his current level of exhaustion he will make a mistake that costs someone their life. He has enormous guilt leaving the ER even more short-staffed but he’s done his part.
For unionization of high-prestige professions, McGill law professors recently unionized, a pretty shocking development as professors here generally consider their work as too independent for unionization to apply. However, the law profs – who likely know more about this than the rest of us – see increasing demands and reduced benefits coming down the pipe so they are preparing themselves to be in the strongest possible negotiating position.
It will be interesting to see if doctor unionization ultimately helps and whether we’ll see it as well in other high-prestige professions.
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