"If I am not for myself, who will be? If I am only for myself, who am I?"
Dear Medical Staff Leader,
Physicians today find it increasingly difficult to just get through the day. Practice expenses are rising, reimbursement is flat or declining, paperwork seems to increase exponentially, and countless other hassles frustrate us at every turn. Yet physicians still constantly strive to do the right thing for their patients while balancing time for families and other personal activities. In the face of these challenges, it is no wonder that physicians seem to be increasingly pulling back into their own worlds, looking out for their own practice interests, and growing apathetic about medical staff activities that don't directly affect their practice. After all, as the saying goes, "If I am not for myself, who will be?"
But can physicians afford to act as if they are an island unto themselves? What if the physician's practice thrives, but the hospital loses money? The hospital will have to cut staff, the physical plant will deteriorate, and it will be unable to purchase the new equipment the physician wants for his or her patients. If the physician's practice is an outpatient specialty, then his or her patients won't get adequate care when they require inpatient services for other conditions.
And what if the care the physician provides is excellent, but the hospital's processes and systems are ineffective? The physician's patients may experience a medical error. In addition, the hospital may be unable to provide timely care--disrupting the physician's work day and causing delays in his or her office. Further, the hospital's staff may be frustrated and demoralized, unwilling or unable to do the extras--or even the basics--to care for the physician's patients.
And what if the physician provides excellent care but his or her peers do not? The reputation of the hospital and the physician will suffer by association. The physician won't be able to trust that the consultants he or she calls or those cross covering his or her practice will provide excellent care. The likelihood of a poor outcome will go increase, and with it the likelihood that the physician is sued.
Will these concerns impact the physician's patients? Will they affect the reputation of his or her practice if this is the hospital with which he or she is affiliated? Will it affect the community in which the physician lives if the hospital goes under? The answer to each of these questions is, of course, a clear "yes". Physicians must have a healthy dose of self-interest for their practices, ability to earn a living, and capacity to just get through the day. But physicians must balance these interests with their connections to the physician community, the medical staff, the hospital, and community. This connection is both self serving and in the service of others. After all, physicians have to look themselves in the mirror every morning and answer the question, "If I am only for myself, who am I?"
That's all for this week.
All the best,
Rick Sheff, MD