The field of medicine in the United States is one of the best in the world, with access to most of the newest technological procedures and developments, drugs and research studies. One would naturally conclude that leads to some of the best health outcomes in the world, but, unfortunately, this isn’t the case. As an example, in 2017, the U.S. ranked 56th in the world for maternal mortality. Our health care system is broken. There are complex reasons for this, but many correlate with a loss of compassion as patients are treated as commodities and profit sources.
After two decades of practicing medicine, I retired from my cardiology practice due to my own health challenges. My friends and family still call on me to help explain their own medical issues. Their reliance on me to explain their situation has shown me how much everyone needs this same service. As a health advocate, I now help people navigate the medical system, translate the medical jargon into plain English and give them a greater knowledge base so they can make better, informed decisions. As I’ve journeyed through the system from all sides — patient, doctor, family member and health advocate — it’s become obvious that compassion is diminishing. There are still wonderful people in the health care system providing it, but as a system, it is quickly disappearing.
Before the pandemic, electronic medical records were installed in most medical clinics to provide better and quicker access to patients’ charts. This is a real plus for health care, but it also introduces patient portals which allow people to independently access their test results. While this sounds helpful, the patient’s inability to understand the findings frequently leads to stress and misunderstandings. Over time, electronic medical records have also shifted the responsibility to the patient to call for clarification rather than having the doctor provide the information. During the same time, in the interest of efficiency, some clinics transformed their reception staff to electronic kiosks. Elderly patients who didn’t grow up in the electronic age can find these machines alienating and frustrating.
As a result of the pandemic, hospitals and clinics have understandably created new policies, but the result has been a further erosion of compassion in health care. As a health advocate, I have witnessed the challenges created when family members are not allowed to visit their hospitalized loved ones or accompany them to doctor visits. While the staff may be discussing the medical situation with the patient, this person is frequently too sick, medicated or confused to understand. Family members are left either endlessly waiting for a doctor’s call or trying to reach an overworked nurse by phone.
While some hospitals have allowed a single visitor for patients during the pandemic, I’ve also seen this implemented in inhumane ways. In one extreme case, a patient hospitalized for a car accident was forced to choose which one of her three adult children would be her sole visitor for her entire stay. The other two adult children came to the hospital to be physically close to their mother but were escorted off the hospital premises by the local sheriff and told not to return.
We need to get back to a position where compassion is at the center of health care. The electronic medical records need to revert to being just a record system, as it was intended, and not a means of patient communication. With appropriate vaccination requirements met, hospitals and clinics need to reopen to patient families. We also need an outcomes-based system that rewards medical staff on the outcomes rather than the sheer quantity of patients or procedures.
Over these past two years, hospitals have been overburdened and the medical staff is overworked, but we are also all in the business of helping people in their time of need. At my medical school graduation, along with my fellow students, I pledged to “do no harm,” but over the last few decades and, especially during the pandemic, this oath is getting lost. The business aspects that have seeped into the health care system are transforming patients from individual customers to numbers and commodities. As health care providers, we need to focus on healing our patients.