Interview

Shahadat Rahman

Professor Matyakubova 

English 21003 

 14 November, 2017

 Research Paper Interview

Interview: Does Medicine Really focus on the Patient?

            This paper seeks to discuss the plights of the current American healthcare system, primarily focusing on how insurance and hospital bureaucracy impede a doctor’s ability to treat patients. This interview was conducted with a pediatrician— who wished to remain anonymous in the event she said something controversial— at Bellevue Hospital. The pediatrician would be able to provide personal accounts of her day and specifically the struggles she faces as a doctor, particularly when treating patients. This could be used to provide ethos in the paper as well as provide a primary source that would expand on how the current healthcare system fails doctors, subsequently connecting that to how it fails patients. She could also explain her initial reasons for becoming a doctor and how these preconceived notions disappeared once she entered the medical field, highlighting the importance of not only teaching medical students about what being a doctor is truly like, but invoking a need to provide solutions to these problems.

Question 1: Why did you choose this career?

I wanted to help people. Although that seems like a generic answer, I thought being a doctor would be the best way to help others. There was this idyllic nature to being a doctor that I could never shake; I always thought it’s what I was meant to be. But being a doctor isn’t the only way to help people. I also fell in love with it because of how intellectually stimulating it was. I love biology and chemistry and I always excelled at it. So naturally, being a doctor was the only logical career choice.

Question 2: You said you thought being a doctor was the best way to help people. What changed?

Well, I became a doctor. I found out that there are a lot of factors that go into treating a patient, other than the diagnosis and a doctor deciding a treatment plan. Factors range from the patient’s insurance to the hospital’s willingness to pay. If a patient doesn’t have good insurance, it can seriously affect their level treatment. Often we see that problems with terminally ill diseases like Huntington’s. They max out their insurance plans and after that we just send them home. Some people’s insurance doesn’t even cover their medication, which can cost hundreds to thousands of dollars per refill. It also doesn’t help that I can only spend a certain amount of time with a patient per hospital regulations. 

Question 3: I shared my story of when I got cellulitis and asked for her thoughts.

That’s exactly what I mean. Hospitals, pharmacies, and insurance companies hardly communicate. I think it’s stupid that your insurance plan doesn’t cover doxocycline hyclate— it’s a simple medication to a common but extremely dangerous infection— but if they didn’t they should have made it clear to doctors so you wouldn’t be running around wasting your time. There’s too much red tape that’s hard to get around.

Question 4: So how does your typical day go, red tape and all.

Well typically I start my day around 6 am as I dreadfully get out of bed. I quickly put on scrubs and head to the hospital. At around 7 am I do rounds on newborn babies. It’s wonderful; nothing wakes you up like crying babies. I see all my patients and don’t spend too much time because of hospital regulations, and then I head to the practice. From about 8 am to 12 pm I have pediatric appointments, about 15 minutes each, regardless of the complexity of the problem, again due to hospital regulations. I usually run 30 minutes behind schedule because not all problems can be solved in 15 minutes. Then take an hour lunch and go back to the practice around 1 pm until 5 pm for afternoon appointments. From 5 pm to 7 pm I do follow ups where I take care of messages, lab results, X-rays, and prescription refill requests. It is critical and needs to get done every day, but I’m not reimbursed. And around 7 pm I leave the clinic and head home. I need to keep my pager on in case there is an emergency. There always is. In that case, I rush back to the hospital.

Question 5: Wow that’s 12 hours a day and a ridiculous amount of work. Do you think it was worth it after 8 years of education and 5 years of residency?

No, not really. In terms of compensation it’s ok but that’s about it. There are too many problems and too few doctors. The red tape just exacerbates the problem. Most of us doctors are overworked with no end in sight. I think if most of us had the opportunity we wouldn’t pick this career again. It’s just not what we thought it would be. It’s more paperwork and less personal care. We don’t even get to spend that much time with patients. Sometimes I feel more like a clerk than a physician.

Question 6: So how do you think the lives of doctors can be improved?

Well first of all the clerical work can be outsourced. Doctors should focus on patients and other people should focus on the clerical work. Most hospitals can definitely afford it. Also we should be able to spend time with patients. As I said before, not all problems can be solved in 15 minutes. Patient history—like if a patient has been feeling depressed and has started drinking a lot lately, or if they have recently taken up smoking—can really affect our diagnosis and how the patient is treated. We can’t talk about these in such a short amount of time. The solution isn’t always as simple as asking what’s wrong, doing a check up, and prescribing some pills.

Question 7: What about health insurance? How does that affect your day? What do you think of the new bill Trump is trying to pass?

I’d prefer not to answer. I know how it affects my day but I’m not exactly sure of the logistics a health insurance company goes through, so I’d sound asinine giving my opinion without understanding their [health insurance companies] side, especially considering Trump care. 

Question 8: How have you seen these problems affect doctors?

The time and energy consumed represents a dimension of health care that goes beyond technical competence. Insurers do not acknowledge the value of these services and rarely compensate primary care doctors for them. As a result, many of them cannot afford to take time off to rejuvenate their spirits. Others have suffered physical and psychological and marital problems trying to deal with the stresses and dissatisfaction of a career in primary care.

Question 9: Do you have kids? What do they think about you being a doctor?

I have kids but I know a lot of doctors make the conscious decision not to. My kids think it’s amazing that I’m a doctor and they love it. But I can tell sometimes they wished I could spend more time with them, and I wish the same too. I’ve missed graduations, dance recitals, school plays. I really miss a lot of things that happen in their lives. That’s why some people decide it’s easier not to have kids, to spare their children the trouble and neglect.

Question 10: If you could get a second chance at a career, would you choose medicine or the same specialty again?

I prefer not to answer.

Work Cited

Personal Interview, in discussion with the author, 5 November 2017