April 2, 2020

Don't forget

I will admit that sometimes being a doctor in the modern medical system can be a thankless job. Most doctors enter medicine to follow a calling, we want to help people! The reality on the ground can interfere. Often there is a conflict between the goals and values of the provider and the system; such as when insurance refuses to pay for a key procedure or drug; or when a patient can’t afford their meds; or they lose their job and their insurance, or if financial incentives are at odds with patient needs. It is tough for us when there are obstacles and competing values that prevent us from helping people.

And health care employers emphasize productivity, asking providers to see more and more patients, while we have to document each visit with a clunky electronic health record. Add in the reality of difficult diseases, diagnoses, social situations, bad outcomes, and lack of support, we can feel the pain and suffering of our patients. It can increase the healthcare providers isolation, loneliness and burnout.

Along with that, much of society blames the doctors, “they are just in it for the money”. Patients blame the doctors for not fixing their lives, when the patient has the power to fix themselves. Or they say we prescribe too many meds, or that we don’t prescribe enough. No wonder there has been an epidemic of burnout in this country.

That is until the past month. The gratitude and the thanks is astonishing. It is energizing and helps keep us going. The hotel across the street (actually a very empty I-5) sent us a love letter today in the form of a heart in their windows. It touched me more than I expected. I am surprised at the power that gesture had. The patients are grateful. Everyone I speak with, see, or My Chart message with, thanks me and I feel their gratitude.

And everyone in healthcare deserves this thanks, not just the doctors and nurses. Don’t forget the physician’s assistants, the nurse practitioners, the medical assistants, the PSR’s who answer the phones and check people in and take the brunt of patient’s fear and impatience. The first responders, which in Seattle are the firefighters and Medic 1, along with police officers and the EMT’s. And don’t forget the housekeepers, the suppliers, the maintenance people, as well as the pharmacists and the physical, occupational, and speech therapists. And truly, the ones working in the ICU and ER’s with high risk, the respiratory therapists who manage all the ventilators-so essential. The social workers and Chaplins are there when they are needed. So many are working to save lives, bring comfort, and get us through this. I may have forgotten some of these helpers, but everyone of these workers deserves our gratitude.

And then there are the scientists working so hard. Two exciting developments today, and one is a new antibody test which has been approved which can show if someone has been exposed to the virus. This will be helpful in many ways. But it is still not clear about immunity but this will help us understand more. The second is that a study is approved to look at a new immunotherapy treatment. So hang in there and be grateful for these things.

And wash your hands! (and wear a mask)

Fun Fact: what I thought was rooftop sitting area, for the longest time, that is on the roof of the smaller building to the left turns out to be a rooftop collection of beehives.

https://www.seattletimes.com/nation-world/antibody-tests-to-pinpoint-number-of-u-s-coronavirus-infections-are-key-to-reopening-country/

https://www.seattletimes.com/seattle-news/seattle-institutes-coronavirus-treatment-study-gets-quick-fda-go-ahead/

https://www.nytimes.com/2020/04/02/opinion/letters/coronavirus-masks.html?action=click&module=Opinion&pgtype=Homepage