Docs feel marginalized in today’s health care system.

I have great respect for physicians. I think most people do. In fact, doctors were ranked in second place (right behind firefighters and before nurses and scientists) in a Harris poll that measured consumer perceptions of the top 23 professions So, why are some doctors having a Rodney Dangerfield moment and feeling like they “get no respect?”

The New England Journal of Medicine recently published an article written by two physicians at Beth Israel Deaconess Medical Center in Boston that suggests that doctors are feeling marginalized in today’s healthcare environment. The authors contend that calling physicians “providers” is demeaning and that doctors’ roles seem to be “interchangeable” with other medical professionals, such as nurses, physical therapists, and social workers. The authors also suggest that the term provider “signals that care is fundamentally a prepackaged commodity on a shelf that is ‘provided’ to the ‘consumer,’ rather than something personalized and dynamic, crafted by skilled professionals and tailored to the individual patient.”

Well, I’m sorry to tell you doctor, the personalized care model of one-doctor towns gave way to large, suburban multi-specialty practices. In addition, today’s electronic reporting has forced physicians to spend more time facing a computer and less time facing the patient. Economics—and, some would argue, better care coordination—has led physician practices to integrate physician assistants, nurse practitioners, and other providers into the care management team. The role of physician and other providers has been blurred by doctors themselves.

But the authors’ concerns do not end with the image of physicians. Pamela Hartzband, MD and Jerome Groopman MD argue that patients should not be called “consumers” or “customers” because these terms are “reducing medicine to economics” and “makes a mockery of the bond between the healer and the sick.”

This is a very parochial view that assumes people only need the services of a physician or other health care provider when they’re sick. It also assumes that patients should be “patient” and accept that the experience they have with their physician is always on the doctor’s terms, not theirs.

I agree with the authors that the economics of health care is getting in the way of meaningful and personal relationships between caregivers and those who receive care. However, I believe their thinking is flawed. If physicians look at health care from the eyes of a consumer, they would see that people—particularly when they are sick and feeling vulnerable—want to be treated with respect, just as any customer does. They would also see that health care consumers are doing their homework and choosing physicians and other healthcare providers based on quality data, clinical experience, and word-of-mouth. Some health care consumers are even pushing back on poor service, such as opting to bill their doctor for keeping them waiting for an appointment.

Whether physicians like it or not, health care is a commodity and consumers are more and more in the driver’s seat. Recognizing and accepting that patients are consumers who have the ability to choose where they receive care will go a long way in helping physicians establish a lasting bond with their patients.

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