The last couple of decades have seen a dramatic shift of power and clout away from individual physicians and towards administrators and the business side of health care. In many ways, physicians have nobody but themselves to blame collectively; because for any large and respected group of people to surrender so much autonomy so quickly, a lack of strong leadership must always be a factor.
So many different reasons for this sea change can be discussed, but the consequences are very palpable. To name but a few, we’ve seen the relentless push towards consolidation and mass employment of physicians, a rise in mandates and bureaucratic requirements, and a general explosion in the number of administrative folks while the number of physicians appears to be shrinking! Then there’s the more subtle changes that the medical profession has also allowed to happen right under their noses, such as the refusal of many in the hierarchy to even call doctors by their true job title anymore — instead labeling them only as “providers” (a subject I’ve written about including an open letter to the AMA and all State Medical Boards).
Speaking as someone who maintains a large network of physician friends and colleagues across the country, some of the stories I’ve heard about what happens nowadays are astonishing. Fortunately, after a few bad experiences, I’m now part of an organization where the relationship between physicians and administrators is probably as good as it can be. But from what I see, this is a rarity.
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