Who owns health care? Part 3: The Physicians

Healing has always been a part of human existence. Somewhere early in human evolution we learned that we could augment the healing process. Oetze the “ice man” the earliest preserved human who died around 3300BC was preserved in ice and found with an herbal poultice wrapped around one of his wounds. Such a poultice was an early version of an antibiotic. As societies formed, medicine men, shamans, and witch doctors were tasked with keeping communities healthy.

In modern society there are many professions tasked with healing; nurses, counselors, therapists, chiropractors, and acupuncturists just to name a few. Perhaps no profession is so explicitly tasked with healing as the physician. The modern physician has roots going back to ancient Greece with Galen and Hippocrates. This lineage extends 2000 years through notable scientists such as Louis Pasteur and Helen Taussig. For every notable figure there were countless others who did the bread and butter work of caring for the ill and will never get credit for it.

The modalities used in healing have steadily evolved. The nature of science and medicine requires constant revision and re-analysis in pursuit of new cures and treatments. The medical miracles of today couldn’t have existed without the trials and errors of generations past. It may seem to some that medical knowledge is owned by the people with the training to use it. With a historical analysis this view quickly breaks down. Dr. Henry Heimlich could not possibly “own” the Heimlich maneuver nor could Dr. Charles Drew “own” the blood transfusion. Both of these advances were developed with and for patients. Therefore it is the patients that benefit from the treatments and physicians that administer them that collectively own this knowledge.

In modern health care most physicians are employed by hospitals or large health systems. Without physicians the hospitals would not have much to offer. In turn physicians have been conditioned to see health care from the perspective of an employee. There is very little accountability for a physician employed by a health system to do anything other than the specific job outlined by the system in question. Flexibility and creativity are not valued assets in this environment. In the last 50 years the majority of physicians have turned from independent practitioners to corporate employees. Also in the last 50 years we have seen our health system turn from a collective of small enterprises with the common goal of health to a collective of corporate enterprises with a mix of goals. During this process patient care has suffered. Many within the system are pushing for positive change. A few brave physicians have ventured outside the established system to offer care on their own terms.

Whether the change comes from within or outside the medical establishment we can all agree that there is room for improvement in health care. As the providers of care, repositories of knowledge, and the face of healthcare physicians should be at the forefront of this charge. We need to demand fair and transparent pricing for our patients. We need to modify our current communication systems so we are accessible and approachable to all. We need to advocate for more time to practice medicine in the way that leads to the best health outcomes, not the most profit. We need to take back power and ownership of healing for ourselves and for our patients. To physicians everywhere - lets take back ownership of healthcare!