The Ugly Secrets Hidden in America's Healthcare System
March 25, 2020
COVID, the hallways are eerily empty because of you. At night, where there normally exists an air of calmness as patients sleep, the hospital walls that surround me instead convey a sense of uncertainty. It is palpable. It is heavy. It is unlike anything I have ever encountered as a physician. Perhaps this is because deep down in places where fear and dread reside, we know you are there watching and studying our patterns of behavior. All the while, you silently spread yourself at exponential rates, knowing that our testing capabilities, while ever-growing, still fail to keep up with you. For this, you mock us. You are learning the truth about the American healthcare system as it stands. On the outside we are strong, with sophisticated buildings, fancy technology, and state-of-the-art equipment. To nearly any onlooker we appear to be thriving, at the top of our game. Yet you aren't fooled by this; no, not at all because you have already penetrated these walls, exposing the hidden prison behind the shiny facade of our healthcare system.
COVID, this allows you to see America's healthcare workers in the state no one is allowed to see, chained and handcuffed to the very system we serve, done so on the exclusive order of our system's prison warden: Healthcare Administration and its Administrators. Our warden works hard to suppress us by minimizing our voice, and maximizing our work output.
For as long as I have been practicing medicine, America's healthcare system has operated on a model of just enough. There always seems to be just enough physicians available to care for patients, just enough nurses to aid patients at the bedside, just enough staff to operate at maximal output with minimal input. Always, just enough of what is needed to marginally practice the art of medicine. Ironically, however, the just enough model never seems to pertain to the warden, his funds or his needs. For decades, the shortcomings of our healthcare system, which restrict the physician's capabilities to practice medicine autonomously and restrict others' ability to deliver the care patients need, has been blamed on us, the healthcare workers. But the prison walls that imprison us are deteriorating as we speak.
As for you, Warden, you have spent decades manipulating and corrupting the system where healing is meant to take place. You have been exceptionally successful at profiting off of the herculean work ethics of physicians, nurses, and all other healthcare employees. You take advantage of our ability, our willingness to be malleable, and to offer care to any and all who are in need. You exploit our altruistic tendencies, knowing they leave so many healthcare workers vulnerable to accepting your often impossible demands. Cunningly, cynically, you leverage this, turning our altruism against us, turning it into monetary gain, knowing we will always be there to fill in the gaps you intentionally leave in the system and economic budgets you operate. You allow us to shoulder the blame for society's dissatisfaction with the healthcare system, even though it very rarely has to do with us. Instead, this dissatisfaction is almost exclusively because of your actions and decisions. Yet still, you refuse to take ownership of what you have created, remaining hidden in the background allowing those who come face-to-face with patients to take the fall. Yet every day we take punches that are not meant for us, punches really meant for you. Your financial wealth shelters you and shelters society from the truth. You are the cause of physician burnout, the source of the low morale that permeates our hospitals and clinics.
For so long, Warden, we have kept quiet about your actions, about the secret chains and handcuffs you imprison us with, because we feared you and what havoc you could cause on our careers. But, your lack of action in protecting us and society from COVID has forced us to take action separate from you. Healthcare workers will no longer hold your burdens nor be held accountable for your lack of preparation and unethical decision making. We no longer fear your retaliation or retribution, because society is on our side, already supporting us, giving us the strength to reconcile the deficits you have left behind, the deficits you have expected us to fill ourselves. We surrender into the shelter of those we heal because the broken state of how you have left us can finally be revealed. Because of them, it is now safe to share the secrets you tried so hard to coerce us into keeping. Our voices can now be heard.
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