COMMENTARY
“Pure” medicine
BY JUSTIN BERK The culture of medicine has changed. Forth- coming ICD-10 codes, meaningful use requirements, and fee- for-service billing dominate medical-industry conversations. Patients are slowly being pushed to the side, replaced by po- litical debates. And physicians are burning out from paperwork and administrative tasks.1
As students, we have noticed this insidious path to disgrun- tlement. The wearing down of phy- sicians who become bitter, burned out, or tempted away from humani- tarianism by high reimbursement rates. Over time, medical students lose their idealism, altruism, and empathy.2-4
As we progress through
medical school, particularly in Tex- as, Osler quotes in the classroom become replaced by Obamacare rants in the wards. Bureaucrats, technology, and increasing health care costs transformed the doctor- patient relationship. Students pick up on the increasing frustration in the profession.
The few oases of “pure” medicine
has become less of a public service and more of an industry followed on CNBC and Bloomberg.
Neither the
are dwindling. Outside of a hand- ful of rural family docs, the culture of clinics and hospitals focuses on efficiency and cost-effectiveness. As students, we’re taught to build rapport expeditiously to save time. We’re taught to sit down when talking to patients because sit- ting creates the perception of having spent more time with them. We’re taught to empathetically say, “I’m so sorry to hear about the loss of your father,” while quickly moving on to elicit the rest of the patient’s family health history. No compassionate physician supports this cultural change. But the constant escalation of health care costs and the nu- merous opportunities for profiting shape the new business of medicine. We order more tests, use expensive imaging services, and perform invasive procedures more than any other country in the world.5
Supply has generated demand. And medicine
Affordable Care Act nor its repeal will ensure that families are able to obtain the care they need.
Pure medicine Besides the county road clinics, there’s another sanctuary of pure medicine without the piles of paperwork. Charitable clin- ics are unaffected by the darker side of medicine that serves to turn a profit. They exist only to serve. In fact, they are often the first places to offer dedicated care to patients most in need. Other clinics may feel pressured to rush indigent patients out the door. For many patients suffering with chronic illnesses, free clinics may be the first — or only — place that devotes the time and has the ability to treat them well. As a student at the Texas Tech University Health Sciences Center (TTUHSC) School of Medicine, I’ve experienced this pure medi- cine at our student-run free clinic. There’s no billing, no paperwork, and no electronic records. At the student-run free clinic, you find only compassionate physician volunteers, eager young students, and patients needing care. After visiting with students,
physicians, and pharmacists to gain a greater understanding of their diseases, many patients recount how empowered they feel. Through grateful tears, patients have shown newfound eagerness to improve their health. They begin to exercise, re- duce their sodium intake, avoid white carbs, and begin to stop smoking. Our greatest successes are not generated from pre- scribed antibiotics. Instead, they come from a sympathetic ear and a compassionate touch. Thankfully, student-run clinics and more than 1,200 other charitable clinics around the nation serve patients regardless of income or insurance status. And the benefits are clear. Chari-
December 2013 TEXAS MEDICINE 7
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