What Do You Think? –The Business of Health Care Depends on Exploiting Doctors and Nurses

Tired doctor

A recent opinion piece in The New York Times has got a lot of people talking, especially nurses. It focuses on the exploitation of one resource that seems infinite and free: the professionalism of caregivers.

The article gives several real world examples that many of us can relate to:

You are at your daughter’s recital and you get a call that your elderly patient’s son needs to talk to you urgently. A colleague has a family emergency and the hospital needs you to work a double shift. Your patient’s M.R.I. isn’t covered and the only option is for you to call the insurance company and argue it out. You’re only allotted 15 minutes for a visit, but your patient’s medical needs require 45.

These quandaries are standard issue for doctors and nurses. Luckily, the response is usually standard issue as well: An overwhelming majority do the right thing for their patients, even at a high personal cost.

It goes on to say that that health care has become corporatized to an almost unrecognizable degree. But it is also true that most clinicians remain committed to the ethics that brought them into the field in the first place. This makes the hospital an inspiring place to work.

The author writes that with mergers and streamlining, it has pushed the productivity numbers about as far as they can go. But one resource that seems endless — and free — is the professional ethic of medical staff members. By far the biggest culprit of the mushrooming workload is the electronic medical record, or E.M.R. It has burrowed its tentacles into every aspect of the health care system.

For most doctors and nurses, it is unthinkable to walk away without completing your work because dropping the ball could endanger your patients. I stop short of accusing the system of drawing up a premeditated business plan to manipulate medical professionalism into free labor. Rather, I see it as a result of administrative creep. One additional task after another is piled onto the clinical staff members, who can’t — and won’t — say no. Patients keep getting their medications and their surgeries and their office visits. From an administrative perspective, all seems to be purring along just fine.

The piece states that this status quo is not sustainable — not for medical professionals and not for our patients.

Mission statements for health care systems and hospitals are replete with terms like “excellence,” “high-quality” and “commitment.” While these may sound like Madison Avenue buzzwords on a slick brochure, they represent the core values of the people who labor in these institutions. Health care is by no means perfect, but what good exists is because of individuals who strive to do the right thing.

It is this very ethic that is being exploited every day to keep the enterprise afloat.

The health care system needs to be restructured to reflect the realities of patient care. From 1975 to 2010, the number of health care administrators increased 3,200 percent. There are now roughly 10 administrators for every doctor. If we converted even half of those salary lines to additional nurses and doctors, we might have enough clinical staff members to handle the work. Health care is about taking care of patients, not paperwork.

Those at the top need to think about the ramifications of their decisions. Counting on nurses and doctors to suck it up because you know they won’t walk away from their patients is not just bad strategy. It’s bad medicine.

Click here to read the article in its entirety and don't forget to share your thoughts in the comments section below.

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Patti West-Truby
1 year ago

Nurses are treated as if we are expendable. The EHR has become the focus of our job due to so much redundancy. When repeatedly entering information in different areas, there is more potential for error. It has potentiated the exhaustion.

Jenny Sexton
1 year ago

Health care is in a sad state. The people who are doing all the work are working long hours and getting paid peanuts compared to the people sitting in the office and making up the rules. Nurses should have united a long time ago to get fair wages, workable nurse to patient rations and pensions. I have been a nurse for over 28 years and retirement is not that far away but I feel that I may not make it due to the stress caused by the expectations of the higher ups. I hope that the new generation of nurses… Read more »

2 years ago

Join together and buy some legislators . Just like they do .

Carolyn Rubin
2 years ago

I am sad that the profession I have given 28 years of my life to, have left me depressed, depleted and wishing I had chose another path all those years ago. Those in the upper echelon of the health care facilities do not go into that business to help people, they go into it for the money. And while they make it hand over fist, we go years without a raise. If this was a male dominated profession this would NEVER happen.

2 years ago

We are getting no help by way of legislation. Changing laws and ENFORCEMENT of those laws will be the only way. Unfortunately, we as providers will have to take drastic steps – like a strike -to make this happen.

2 years ago

With this being a predominantly female profession, this will continue to happen because nurses allow it. We are 3million plus strong. So what’s up nurses?!
We could make drastic changes for the betterment of our patients and ourselves, if we handled our business like we should!
Hospital inpatient units cannot
Operate without nurses.
We need to stop talking ISH!!
And become more aggressive in our pursuit of better treatment!!

frank lomprez
2 years ago

Just worked 400+ hours as a RN in 30 days. For profit facilities are the worse.

2 years ago

I’ve been a nurse for 30+ years and this article is soooooo true, we give until we have nothing more to give. And beside a stagnant income ( administration get ridiculous increases) I have joints that hurt every day, go home physically and mentally shot, less ability to care for my aging parents or play with grandkids. Not sure it’s worth it. I know I have made positive impact in people’s lives but at what cost? We caregivers have a lot of pride in the care we give but the “fat cats” keep raising the bar- they know we will… Read more »

Steven Schiess
2 years ago

I have always said this is the exact thing wrong with the healthcare system! It has become big business and there is a disconnect between hospital administration and front line caregivers. I love the part about administrators using words like best patient care and excellence, they have no idea how to apply those words to actual patient care.

JoAnn Fischer
2 years ago

Health care of ALL kinds is terrible and non-exit. Its all paper work and referrals and more paperwork. Hardly any treatments are given to make a person better.

2 years ago

Nurses are bent too the limit. It won’t be long before we break. Also, the next generation of nurses won’t allow a work environment like that.

2 years ago

Very well said !!!