Louisville Medicine Volume 63, Issue 9 - Page 12

PATIENTS NEED OUR HELP WITH ACCOUNTABILITY (BECAUSE THEY CAN’T AFFORD HEALTH CARE ANYMORE) Brian Sosnin, DO I remember, shortly after completing residency at the beginning of my career, sitting at one of my first GLMS meetings. I was at a large table, accompanied by several other physicians who had been around the block a few times and some of the GLMS staff including Lelan Woodmansee. One physician at the table said that doctors would soon be “held accountable” by both insurance companies and the health care system for patient outcomes and patient compliance. But there was an additional, coded message in the framework of the statement this doctor was making that said, “and the patient isn’t going to be ‘held accountable’ for their own outcomes, like the doctor will be.” I had previously thought about this issue but figured someone would surely make this fair, and bring patient responsibility and accountability into the health care picture for serious discussion, sometime soon – surely! But on this day at the GLMS meeting table, although I had not opened my mouth or 10 LOUISVILLE MEDICINE said a word, the physician next to me looked over at me, looked me straight in the eye, and said, “You better accept it because it is coming, whether you like it or not.” I thought to myself, how did he know what I was thinking? I hadn’t said a word. I was blown away that he sensed the uncomfortable feeling I had that “This just didn’t seem fair.” He was obviously in tune with me and recognized my subtle body language very quickly. It was quite remarkable. I still thought it wasn’t right and leaned towards rejecting the idea as unfair and unhealthy. A year or two went by and I found myself at a drug rep dinner listening to a psychiatrist talk about how doctors need to do better at improving patient compliance. Within just a few minutes I was angry and wanted to stand up and let my disagreeing spirit be known. But, I didn’t want to be the heckler that ruined the evening, so I bit 436 holes in my tongue and kept silent. By the end of the lecture I found myself mysteriously and miraculously believing that I can make a difference in patient compliance, responsibility and accountability. I was at least convinced that I could make a difference