How to Serve 3 or 4 Sick Care Masters ?

It used to be all that doctors needed to do was serve the primary interests of their patients. Of course, private practice has always been a conflict of interest.

Then came the corporatization of medicine and the subsequent rise in the numbers of employed physicians, approaching 75% of the physician workforce, and they have to make the numbers. Now, we have added a third master-society in general, given the rising clinical and business disparate outcomes recognition of the importance of social determinants of health.

But wait. There is more. Now that all of you are burning out, you are expected to take care of yourself too. Given your 60-80 work weeks and pajama time catching up on those pesky EMRs, how's a girl or guy supposed to find time to do meditation, mindfulness training, joga, Pilates, kids time and all the rest?

Expecting doctors to serve three, if not four, masters comes with baggage and problems:

1. They are neither willing nor able to do it
2. They don't get paid to do it
3. They have neither the tools nor resources to do it even it they wanted to
4. They have conflicts of interest
5. They don't have control of the outcomes
6. They are disconnected from stove-piped social support bureaucracies
7. Someone else wants the credit and has competing interests
8. The ROI on investment does not accrue to short-term, bottom line focused bean counters and admintrators
9. It takes another chunk out of already limited face time with patients and their families
10. There are few, if any, incentives to do it given perverse compensation schemes.

Satisfying all these interests is another wicked problem that has to resolve the competing interests of colliding ecosystems. In the meantime, my guess is most doctors will smile, pay lip service and try their hardest to just take care of their patients and let the chips fall where they may until some data scientist figures it all out using AI and blockchain. Then, when they do, we can give them the sick care Masters green coat every April.

See you in Augusta.

Arlen Meyers, MD. MBA is the President and CEO of the Society of Physician Entrepreneurs