Do Doctors Care Anymore?

Since the advent of the Health Maintenance Organization (HMO) decades ago, the connection between patient and doctor has become increasingly slight.

As a kid I went to a family doctor whose office was around the corner. His office was in a single-story building with cedar shingle siding. All the machines inside stood out like 10-penny nails on a plank of pristine pine because of their bright white color and modern shapes. My hometown was very rural and going to the doctor was like going to an important meeting in a science laboratory. What was most pleasant about going to the doctor was that he remembered me, seemed to take his time finding out what I was suffering from and asked about my family, school and all the other stuff. I felt like Dr. Adams knew me. I felt like he cared about me.

Today, I don't think of my doctor as a caring person. I see doctors as people to use for a solution to a problem. I no longer feel any connection to him. If it were not Dr. Lee, it could be Dr. Smith. They are interchangeable. I have no relationship with any of them and so they are practically disposable. In fact, I don't really think of him as "my doctor." I call him "a doctor" or "the" doctor. And I see the organization he works for as a big corporation conveying all the warmth of a stainless steel teddy bear.

But, today I was surprised by an early morning phone call from Dr. Lee (well, Dr. Lee's secretary, of course.) She said the doctor noticed I had not been in for more than a year and he wanted to see me. How odd! Had he found something deep in my file (or somewhere else) that I should know about? Nope. He just thought it wise for me to get a checkup.

Immediately I said no thanks. My co-payment is $50. I don't have any medical problems right now and don't want to pay 50 bucks to have my blood pressure and pulse taken. I guess I'll go in when something is wrong. Then came a second call three hours later. And another two hours after that with the same request.

Suddenly I felt grateful. My $50 won't make or break them. Mind you, if they get 25000 patients to come in the HMO will make some meaningful money. And from their standpoint, it is good for them to know what's going on with me. It helps them project care needs and how much my premium will go up. HMOs have certainly helped make me believe healthcare is about money not care. But, I have to say Dr. Lee's phone calls softened my posture. I guess I felt more cared about than exploited.

Is it possible that Mega-HMO company doctors really do care? I am not ready to go that far. If six months from now I get another call or a birthday card this summer I may change my mind. I'll let you know because I think it is important. The more large companies do to improve the interpersonal caring between their employees and their clients, the better the whole world will be. To Mega-HMO and Dr. Lee I say...keep going. You may just win me over.

Technical Problem Fixed

Dear Faithful Readers,

You may have wondered why there were so few postings in May. Turns out my blog software had a problem I could not fix.

I no sooner got my friend and web-guru Adam Levenson of www.pixelgroove.com on it and the problem magically disappeared.

So, I will resume posting and we will be in contact again. I look forward to that - and exchanging thoughts with you.

~ David

Change Requires Conversation

A few weeks ago syndicated radio host Don Imus was fired for making degrading remarks about the Rutgers University women's basketball team. By almost any standard other than his own maybe, his remarks were regarded as racist. So, after a short brouhaha played out in the media, Imus was fired. MSNBC dropped his program from television and CBS fired him from their network. Not long after I asked readers in this blog why they thought he was fired.

At the time this was national news. Why? I thought at the time that something shifted in the nation's consciousness--that flagrantly racist ideas spouted by media figures are not acceptable. I wonder if anything has changed though.

Critics of both CBS and MSNBC said others with a public pulpit had long been denigrating blacks, with more or less finesse than Imus used. Why, they asked, was it okay for comedians and rappers to make overtly racist remarks and not for Imus?

The president of CBS said that "there has been much discussion about the effects language like this has on our young people, particularly young women of color trying to make their way in this society. It is important we stand with the women of Rutgers who [were] deeply hurt by the highly insensitive comments of Don Imus." On television he said he did not think racist commentary was the kind of conversation his organization should be having with radio listeners.

That idea struck me. In that sentence is the sentiment (and professional judgment) that there is a conversation we ought to be having.For a short while after Imus was fired we were talking about race and degradation and what we should reasonably expect from a radio shock-jock.

And then a horrifying event happened at Virginia Tech and Imus was off the national conversation stage.If it weren't Virginia Tech, almost surely it would have been another more immediate story. And that is a shame, because change requires conversation. The bigger the issue the more conversation it takes. But, when we move on to the next story or issue or pressing "to-do" item on our list, horrible or happy as it is, we shortcut the process of engaging in deep-enough conversation - the kind that can help change us for the better, permanently. We run the risk of staying at the level of the headline and not diving into the deeper questions that confront us.

Keep that in mind. If you find that you fly from one hot, pressing, this-instant issue to another, you are very likely not diving deep enough into the core issues that are really important. I wonder if, as a nation of news consumers - and neighbors to one another - we have done just that.

David Facer helps executives achieve a positive change in behavior for themselves, their people and their organizations. He works with both first-time managers and seasoned executives.