The Physician Position
The Best Defense is a Proactive Offense
Physician deficit, burnout, and scope of practice – these terms have become all too familiar when discussing the state of health care in 2023. Overcrowded, underserved medical facilities. Overworked medical professionals. Physician-less teams. The majority of you who may be reading this article know the reality of this issue. But, let's say for the sake of the discussion, you are reading this with no prior knowledge on the subject. Here's a relevant scenario with a "Southern parallel”, if you will…
It's quite possibly the most scrutinized, yet coveted position for an athlete in American sports. It requires leadership in victory and defeat. It requires countless hours of preparation and situational precision. With it comes expectations of confidence, grit, charisma and control. The ones who are best at it know the strengths and potential weaknesses of every member of their team. They have an uncanny ability to maximize each individual skill set to achieve a superior level of success.
The best ones are surrounded by teammates committed to that same level of success and realize that success comes when every member plays with an aligned expectation. It's a role they didn't take lightly, but one that they decided on easily. Because it was a calling. Leadership and the desire to catalyze change are in their DNA and nothing short of legal force or natural disaster could have derailed their course.
In both victory and defeat, by praise and by blame...it's the quarterback who assumes the responsibility.
The Quarterbacks are Disappearing
So, what if the upside was gone? What if the rewards and responsibilities of being a quarterback were mere shells of what they once were because of political and special-interest interference? What if the GAME of football ceased to have any resemblance to "football" at all? What if, for the sake of the bottom line, quarterbacks were replaced with, say, “left outside linebackers”? (Nothing against the guys in the trenches. Their strengths likely lie in other, more brutal areas of the game.)
What if an up-and-coming quarterback's calling was greeted in such a way that the cheers of the fans became as muted as the calling? What if political resistance and external interference along the way overshadowed the once-unwavering pursuit? What would the next generation see? Who would they look to? When would the standards, once held high by the leader of the team, cease to be standards at all?
Would the absence of a quarterback affect the quality of a game? If so, WHO all would be affected? HOW would they be affected? Would the absence of the QB eliminate the need for one? Or would it force another highly skilled position player to do their best to fill the role? What would be the outcome? Would the result of that outcome produce an immediate, winning result? Would the "learning curve" be acceptable to team ownership and invested fans who require unanimous victory from every outing? Would the standard of the team remain exceptional, or would it eventually migrate to an "acceptable" level? Follow this same narrative and apply the far-reaching effects to medical team morale, patient care quality, and the overall level of confidence placed into the system.
The quarterbacks are disappearing and health care is being forced to adjust. The concept of BEST scope of practice doesn't devalue anyone on the team, rather it utilizes experts in their field in the very role in which they are extensively trained to achieve the highest level of excellence. It requires every member to contribute their own irreplaceable, professional set of skills.
What Happens Now?
The physician deficit in the US is increasing at an historic rate, leading to financial, mental, medical, and even legal strain on the very institutions and individuals who are providing the care. The expanding scope of practice is ultimately forcing those with very specific training to reach beyond their range of expertise and assume unintended responsibilities.
The Physician Position is Disappearing
It's time to start talking about it. It's time for medicine to again be led by physicians who will once again clearly hear their calling and be the example for the next generation. It's time to take a look at what physician deficit really means. It means a deficit in standards, leadership and accountability...a deficit that most football fans would regard as unacceptable on the gridiron. So, why would we allow it when it directly effects our lives and the lives of our kids and grandchildren?
A slow fade to medical mediocrity would be catastrophic in a country where the call to being a physician should be without interference. It should be an unencumbered pursuit that is as fulfilling as the destination.
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