Sunday, August 21, 2011
Back for more!
I think I'm ready to again take up my lance and tilt at the windmill of changing the paradigm of treatment in this country (if not everywhere!) I haven't been posting mostly because I've been overwhelmed with the realities of trying to earn a living seeing patients in a heavily managed care environment. I've learned a lot, some of it quite painfully. I think in the long run it will serve me, and hopefully others, well, because this is a harsh, difficult and treacherous environment. I understand much better why physicians avoid particularly challenging patients, and why they are so conservative in their approach. Everyone is overwhelmed. There are so many patients we really don't have any treatment for or even understand what is wrong with them. It feels like we are putting Band-Aids on gaping infected wounds and sending people out the door. Many are simply left to cope on their own. All of this has been exacerbated by the Great Recession, which is wreaking havoc on anyone but the wealthy, and by a system of care heavily dominated by procedure-oriented specialty care rather than compassionate, comprehensive care. One reason for feeling overwhelmed is that it all seems so well, overwhelming. How can anyone hope to change this terribly dysfunctional system? Lately I've adopted the strategy of focusing on smaller, more achievable goals. This fall I will start seeing more patients in private practice and fewer in a managed care setting. I hope to build on this seedling to establish the first ALLTYR Clinic. Wish me luck.