Below are some comments by physicians that were posted on Medscape, a highly regarding publication for doctors.  This is not a comprehensive discussion, but it does give some idea about the prevailing mood among the medical profession in 2016:

Until the 1980s, doctors for the most part owned or controlled their means of production and conditions of practice. Although their work often was challenging, they could decide their hours of work, the staff members who worked with them, how much time to spend with patients, what to write about their visits in medical records, and how much to charge for their services.

Now the corporations for which doctors work as employees usually control those decisions. Loss of control over the conditions of work has caused much unhappiness in the profession.

Most doctors have become highly paid employees of hospital and health system corporations, and around one half of doctors report feeling burned out.

An internist lamented that medicine “has become all about the almighty dollar and nothing about the care of patients.”

Numerous comments related to concerns with one-size-fits-all tasks that enforced standardization—think paperwork, bureaucracy, electronic health records, rather than individualization—with a goal of meeting the needs of the corporation rather than those of patients.

A family physician voiced concerns that healthcare corporations and physicians were inherently at cross-purposes: “A corporation is ethically and legally obligated to make a profit; I get that. The ethical obligation of a physician places the interests of the patient first.”

One internist noted, “Making the public aware of what is happening is a must for our survival and quality patient care.”

“I have quit jobs that paid much better in order to avoid the corporate bureaucracy that has overwhelmed and nearly destroyed the profession for which I and many of my contemporaries sacrificed so much and delayed gratification for so long.”

“Doctors have allowed themselves to be defeated because they have valued the love of security over the love of freedom, and what they have found is that security is an illusion and the corporate bureaucracy is a much harder taskmaster than most of them ever imagined.”

BLOGFINGER MEDICAL COMMENTS:   By Paul Goldfinger, MD, FACC

When Obamacare first was passed, I wrote a series of articles on Blogfinger predicting that this new healthcare system would compromise the doctor-patient relationship and would reduce quality of care. I sensed that early, because it was clear that doctors would not be able to provide highly individualized care, as they have been trained to do.  Maybe formalized care using guidelines and physician extenders would work for most medical issues, but it is those cases with the quirky and concealed elements that separates the men from the boys in medicine, and then mistakes are made and patients can suffer.

Many physicians now complain that regulations which are imposed on doctors often are not based on research evidence and contradict the first rule in medicine to place the patient’s best interest first. Instead, the bottom line prevails.   That has become true in a variety of ways. It is now common for doctors to complain that their corporate task-masters have gotten in the way of good medical care.

“Put patients first,” declared Harvey Fineberg MD, president of the Institute of Medicine, the health arm of the National Academy of Sciences.  “If you put your patients first, everything else will fall into place.” He was addressing the class of 2013 at Harvard Medical School. 

But I guess it was easy  for Dr. Fineberg to make that statement in 2013, but things are often not falling into place these days, and those 2013 graduates, filled with idealism, by now might be wondering if they will be able to take his advice as they enter the reality of practice in 2016 and beyond.

Unless decision making about medical practice is restored to doctors, most of you will increasingly run into problems as you seek quality care for yourself and your relatives.

THE BLIND BOYS OF ALABAMA:  “You can’t be a beacon if your light don’t shine.”