Anyone who has visited a doctor lately has noticed the entire framework has changed. While there are still a few independent groups of doctors who wish to care for people and help them with their problems, many of us have found that our favorite doctor now works for a large conglomerate hospital system or other entity. You no longer know the staff; your doctor is now practicing one size fits all medicine. Beginning at the primary care level, the new game is to make a diagnosis and refer to the system, regardless if it is the right thing for you. The hospital is being paid every time you visit a specialist and your doctors are selling your procedures or passing you around. The sales pitch is usually done after the doctor orders the test to "diagnose" your ailment. Many doctors who are now working for "the man" are incentivized to do this with no incentive to figure out what is wrong with you but there are large incentives if you refer within the system. Also, problems are not cured but managed with many drugs that now create dependency on the systems. Many doctors are now questioning the ethics of this system they are now trapped within and some are just burning out from not being able to think outside the guidelines to help a patient. The result is poorer outcomes, higher costs, greater frustration from patients, and a general distrust of the entire system which has allowed insurance companies through Obamacare to run amuck and force consolidation by starving independent practitioners financially. While our system is far from perfect, single-payer healthcare would be a first step in reforming the mess while simplifying the system and promoting competition, access, and quality. The NY Times recently did an article on this you should read. Check it out below The Moral Crisis of America’s Doctors The corporatization of health care has changed the practice of medicine, causing many physicians to feel alienated from their work. By Eyal Press Published June 15, 2023 Some years ago, a psychiatrist named Wendy Dean read an article about a physician who died by suicide. Such deaths were distressingly common, she discovered. The suicide rate among doctors appeared to be even higher than the rate among active military members, a notion that startled Dean, who was then working as an administrator at a U.S. Army medical research center in Maryland. Dean started asking the physicians she knew how they felt about their jobs, and many of them confided that they were struggling. Some complained that they didn’t have enough time to talk to their patients because they were too busy filling out electronic medical records. Others bemoaned having to fight with insurers about whether a person with a serious illness would be preapproved for medication. The doctors Dean surveyed were deeply committed to the medical profession. But many of them were frustrated and unhappy, she sensed, not because they were burned out from working too hard but because the health care system made it so difficult to care for their patients. In July 2018, Dean published an essay with Simon G. Talbot, a plastic and reconstructive surgeon, that argued that many physicians were suffering from a condition known as moral injury. Military psychiatrists use the term to describe an emotional wound sustained when, in the course of fulfilling their duties, soldiers witnessed or committed acts — raiding a home, killing a noncombatant — that transgressed their core values. Doctors on the front lines of America’s profit-driven health care system were also susceptible to such wounds, Dean and Talbot submitted, as the demands of administrators, hospital executives and insurers forced them to stray from the ethical principles that were supposed to govern their profession. The pull of these forces left many doctors anguished and distraught, caught between the Hippocratic oath and “the realities of making a profit from people at their sickest and most vulnerable.” Read more