Atul Gawande is an authority on the complex issues facing today’s physicians. Dr. Gawande is a MacArthur Fellow, a general and endocrine surgeon at the Brigham and Women’s Hospital in Boston, a staff writer for The New Yorker, and an associate professor at Harvard Medical School. He’s written several books including the New York Times best seller, The Checklist Manifesto. This year, he delivered the commencement address at Harvard Medical School.
In his commencement speech, Dr. Gawande states, “We are at a cusp point in medical generations. The doctors of former generations lament what medicine has become. If they could start over, the surveys tell us, they wouldn’t choose the profession today. They recall a simpler past without insurance company hassles, government regulations, malpractice litigation, not to mention nurses and doctors bearing tattoos and talking of wanting “balance” in their lives. These are not the cause of their unease, however. They are symptoms of a deeper condition—which is the reality that medicine’s complexity has exceeded our individual capabilities as doctors.”
Call pay: a symptom of a deeper condition
Call pay is a perfect example of a pain point in healthcare that’s really a symptom of the deeper condition Dr. Gawande refers to. Therefore, solving the issue of call pay requires an understanding of its underlying causes and a systematic approach that will help resolve them. When handled with the traditional method of single-specialty negotiations, call pay only exacerbates large-scale issues like medical staff division and unsustainable financial pressures. But when properly handled, call pay can be transformed from a symptom to a solution, and we believe this is true of many of the issues physicians are facing.
A cause for hope
Dr. Gawande’s observation that most doctors of older generations wouldn’t choose the profession again is perhaps his most startling given the fact that there’s a growing physician shortage in America. But the success of our solutions points to a cause for hope. As Gawande states, “medicine’s complexity has exceeded our individual capabilities as doctors,” but this only means that doctors will be called upon to band together. We have experienced first hand the good that come from the implementation of physicians’ committees, broader participation across specialties, and improved physician engagement. We believe productive collaboration can transform the landscape of healthcare, creating future generations of doctors who will look back on their professional careers and feel very lucky to have practiced medicine.
Dr. Gawande’s commencement speech was printed in the May 26, 2011 issue of The New Yorker under the title, “Cowboys and Pit Crews.”
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