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Review: "Doctors Unionize to Resist the Medical Machine" – The New York Times

This was a story written by Noam Scheiber and published by the New York Times today. The author describes a common situation: physicians who want to be thorough run up against administrators who want to make money. The physicians feel trapped because they don't have individual influence enough to make their desired change. In this case, the remaining doctors formed a union.

Please read the article and then ask yourself the following questions:

  1. Why do doctors feel trapped in a job they feel they can't control?

  2. Why are administrators making medical decisions?

The interpersonal and logistic dynamics introduced by this article are both super obvious and incredibly subtle – to the point that I actually feel a bit overwhelmed teasing them apart. So I'll save that for a day when you, reader, and I can talk in person.

Here's how P.S.Y.C.H. would handle many of those dynamics:

  1. All doctors aren't cut from the same cloth. As much as I respect my fellow providers, we all have opinions, and getting us to agree on anything can be tough. In fact, the idea of unionizing is not one that appeals to me personally. What we do agree on universally is physician and patient autonomy. In other words, patients and doctors should have the ability to choose what they want to choose. P.S.Y.C.H. creates and imbues that into every decision, both medical (patient-provider) and professional (provider-provider). I would envision hospitalist groups forming their own companies and leasing a building space (from a hospital) – the patient paying the provider and the provider paying for the space. In other words, some "hospitals" would be more like "medical hotels."

  2. Doctors' companies will have their own administrators, not third-party administrators. Since patients will pay the providers directly, and most doctors such as myself hate dealing with the business side of things, we'll have our own administrators who answer to us and interact with patients, field complaints, help with follow-ups, etc.

  3. Hospitals will adapt. I purposefully left hospitals out of the P.S.Y.C.H. plan structure because they are private entities that will find their own way to make money. Whether they switch to the "medical hotel" model or not, they will find a way to streamline their processes and stay competitive. Or they'll go out of business. Note: there is a difference between teaching hospitals, community hospitals, and private hospitals (we'll discuss this on a different day).

  4. Doctors have flexibility: I'll write a separate post explaining this.

P.S.Y.C.H. returns autonomy and choice to both patients and physicians and can't come soon enough.


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