Ethics in Health Care

I have a very unique and privileged position in the current healthcare environment. Not only am I blessed to be a clinician (see patients), I have the additional honor of being involved in the administrative aspect of medicine as well. Because of my unique position, I hold many committee memberships. One of those positions added recently was for my hospital’s ethics committee.

One topic discussed in most committees is the upcoming flu season. People don’t realize the planning that hospitals endure in preparation for a possible pandemic. The need for intensive care unit beds, ventilators, additional staffing requirements, etc., are discussed as much as the joint chiefs of staff may discuss their available resources for an upcoming defensive or offensive deployment.

Our recent discussion concerned the need for personnel in case of a disaster, including a flu pandemic (we are due for a true pandemic-not a media generated hysterical fake pandemic, but a real one). Our discussion centered on the response of the hospital’s staff, nursing, ancillary and even physicians. I was always under the impression that we always show up for work, regardless of our own states of health. In one of my earlier posts I even vented when I had to get up during a “snow emergency” and go to work when everyone else, including civil servant emergency personnel, stayed at home.

Our discussion turned into a real eye-opener for me. My take on the whole issue was that if my family were safe and didn’t need my immediate attention, I would be at the hospital caring for patients and staff. I’ve always wanted everyone who knows me to think of me as a regular person first, then as a physician. Being a physician was always what I did, not who I was. After our discussion, I doubt there are many people, much less physicians and healthcare personnel, who will be there when we need them.

Most members of the committee (all had been members long before me and had this discussion before) had a sense that a significant percentage of personnel would stay at home in the event of a disaster (tornado, flood, terrorist attack, flu pandemic, etc.). They have even gone so far as to plan for daycare services for employees to encourage them to come to the hospital.

The trend of non response is a direct reflection of the younger, more selfish, generation. Physicians my age and older would respond without hesitation. We are also the physicians who used to work 80-100 hours per week as residents learning to take care of patients. We were overwhelmed on a daily basis and learned to deal with the stress that comes with it. We learned to triage patients over the phone because we had seen SO MANY patients during our short careers that it became second nature to us. Common things occur commonly, and we saw many of them. Because of the large volume of patients, we also got to see many of the uncommon things first hand, not hear about them from someone else the next day. This hard work gave all of us the work ethic that most people attribute to their older physicians.

The newer , younger, physicians are the ones who, as residents, had mandated limited working hours, scheduled time off and limits on the number of patients they could care for. More technology and fewer patients means less “hands on” direct patient care and experience. These physicians have become so accustomed to the reduced working hours that they are all looking for 40 hour per week jobs, 9-5, no call and no weekends. Boy, wouldn’t that be nice?? And you know what? There is such a shortage of doctors in some areas, that some of these physicians are getting exactly what they want.

The work ethic of your parent’s doc, or maybe your own, is a thing of the past and will be dead and completely gone when I and mine retire. So when the pandemics or disasters hit, don’t be surprised if that new young doc who just graduated and moved into your neighborhood isn’t huddled at home with you.

Doc B

My opinion is free.
Advice is worth exactly what you pay for it.

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