Physicians may not use paintbrushes or pastels, but the techniques they use when treating patients show they are nothing short of artists. When their autonomy is taken away, what do physicians become?
"The biggest threat facing physicians right now is the business of medicine. Medical care for physicians has become much more of a business from every aspect compared with what used to be the 'art' of medicine," Vikas Patel, MD, executive vice chair of University of Colorado Medicine in Denver, told Becker's in a March 10 interview.
One reason for this is that physicians are largely left out of the discussions that affect them the most. Especially when it comes to healthcare policy.
"Physicians have been 'relinquishing' their power in the healthcare system for a long time," Vladimir Sinkov, MD, founder and CEO of Sinkov Spine Center in Las Vegas, told Becker's in a Feb. 28 interview. "The three major areas where physicians lost their influence over the healthcare system are hospital control, financial relationship with the patients, and the need to practice 'defensive medicine' in an effort to avoid a frivolous lawsuit."
As of January 2021, 49.3 percent of physicians were employed by hospitals, according to a report by Avalere Health. Physicians employed by hospitals have pay that is tied to certain metrics that often have a lot to do with reimbursement rates. They may be asked to follow the hospital's best practices, but those may not be the choices they want to make.
"What's even worse is the increasing trend of hospitals employing physicians," Dr. Patel said. "This, then, really becomes a business employment and the primary goal of any business (even nonprofits) is to generate revenue. Physicians are then the focus to see more patients and pressured to do more procedures and surgeries. This becomes even more of a factory mentality with a tremendous focus on throughput."
Physicians who aim to keep both their autonomy and artistic freedom may consider being independent in the future. That mindset could be one reason behind why 60 percent of ASCs are still physician-only owned.
Forty-seven percent of physicians reported experiencing burnout, according to Medscape's "Physician Burnout & Depression Report." Thirty-six percent of physicians said increased control and autonomy would help reduce their burnout.
Giving autonomy back to physicians would not only help them mentally, but it has the potential to preserve medicine as an art form.