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An Argentinian Physician’s Commentary: Don’t Blame the Physicians

Federico Acharta, MD, weighs in from Argentina, in a response to an anonymous article that puts blame on physicians for deteriorating well-being & job satisfaction.

In Argentina, a “supposed letter” by an ANONYMOUS author (no one ever claimed responsibility) has been circulating on social networks for several years, written by a lawyer to a doctor who tries, with acid irony, to describe the current employment situation of doctors in our country… Is the situation of Healthcare Physicians really so bad in the labor, social and economic aspect?

No one has ever claimed its authorship and from what one might think it is a form of literary “vent” by a doctor written from the perspective of a lawyer.

It is quite an extensive text so I will translate for this article the most “interesting” passages of it so that doctors, health workers and other professions can have a general overview of how the conditions of work of what I guess to be at least 50% of doctors in Argentina (beyond the ironic tone and the exaggeration used as a way to generate a greater dose of “humor” in the publication…)

 

Letter from a lawyer to doctors:

The puppets of the art of healing, puppets of social works, hospitals and prepaid medical care systems work where and how they can. Their social responsibility makes the institutions work and their personal irresponsibility leads them to uselessly expose themselves.

The day they, true doctors by vocation, stop thinking so much about the patient, about their professional training at any cost, about the institutions they work for, and become aware of how much they risk in each medical act, that day the attention of the country will be paralyzed.

Because only a madman, someone who has lost the ability to discern between goodness and stupidity, can accept the responsibility of shuffling a human life when a perverse and lacking system in every sense does not provide him with the security and tranquility necessary to work properly. .

The doctor who assumes responsibility in a surgical act, who submits to the stress of deploying his art on a sleeping patient, who takes on the fight against someone else’s disease, who defies death knowing that he will not always succeed and who accepts doing it for the shameful remuneration that the system assigns him, that doctor is not good, he is STUPID, he is someone who consumes all his intelligence in the scaffold of his personal offering to a neighbor who does not recognize his effort. His patience exhausted, he can no longer see that an error, even an involuntary one, can cost him his assets, his well-being, his health.

 

This “altruistic suicide” appears in all the cards of the prepaid medical care systems. He works in national, provincial or municipal hospitals, overwhelmed by a barrage of patients who age in queues and, frankly, receive poor care. He wanders around clinics and sanatoriums collecting coins to survive.

This doctor, suicidal by vocation, intelligent for others, and brainless for himself, good and stupid at the same time, responsible to society and irresponsible to his family, is the fodder of the cannon, the center of the target of the ” bad practice”.

Every lawyer knows that in this perverse system, so lacking in resources, so tampered with by unscrupulous enriched at the expense of health, the doctor is the easiest “thin thread” to cut, the ideal candidate to squeeze, the easiest naive to shake, to rescue the coins they carry in their pockets.

What few have thought about is that, ultimately, this medical cruelty, which does not discriminate between suitable and incapable, between good and bad, decent and debased merchants, is fundamentally detrimental to the patient.

 

The entire community begins to suffer the consequences when the trained doctor, with experience, with recognized prestige among his colleagues, begins to “dodge” the difficult pathology, the one where he risks a lot and gains little.

The doctor who watches your back discriminates out of necessity.

The community suffers from this reality, being deprived of the suitability and experience of its best doctors. Because the best, also the most intelligent, quickly see the need to step aside so as not to expose themselves.

While it is true that some doctors are not used to taking responsibility for their actions, it is also true that the vast majority would not have to work under the current circumstances.

They risk a lot without gaining anything. Because if a surgeon has to face a lawsuit for malpractice, the demand exceeds thousands of times the compensation for his work. A $1,200 intervention can turn into a $120,000 judgment.

 

Doctors risk a lot without gaining anything. Because if a surgeon has to face a lawsuit for malpractice, the demand exceeds thousands of times the compensation for his work. A $1,200 intervention can turn into a $120,000 judgment. Click To Tweet

 

Thus, the prepaid health care systems, circulating through, ask their doctors for a photocopy of the subscribed insurance policy.

They, in the best style of Pontius Pilate, pretend that the doctor, with the pennies they are assigned for their work, hire “malpractice” insurance.

In this way, the leaders of prepaid medicine cover themselves from errors in the service they claim to provide. They achieve their goal without sacrificing a single penny from their coffers. With current tariffs, no doctor can insure against “malpractice.” Fearing “malpractice”, none can work as they should.

 

The rise of this type of lawsuit is not the fault of the lawyers.

They, who are many and must subsist, have seen the shortcomings of the system that place the doctor in the first line of fire. As a fragile fuse of a medical machine in constant short circuit, the doctor jumps and burns.

Win or lose, right or wrong, right or wrong, the doctor must pay.

Society seems cruel to those responsible for ensuring health.

 

Fearing “malpractice”, none can work as they should.

 

SUICIDAL vocation to continue with this profession that has the highest rate of divorce, alcoholism, premature deaths, and the lowest in remuneration compared to other classics. Altruistic suicide!

The professional in a dismantled, and worn out, institution wears out!

They wear out!

 

Unfortunately, I must admit that I largely agree with the content of this letter/statement and that in the country where I live (Argentina) most of what is described in the letter (although often exaggerated or taken out of context) is REAL. Which is still sad, dangerous for the health system, for the psycho-physical health of health professionals and for the patient himself.

What can my colleagues tell me (in this case I am an Intensive Care Specialist Physician) from other parts of the world… The employment situation of the Medical Community in General and of Intensive Care Specialist Physicians in particular is as bad as described this letter…???

I would love to know more about various situations in multiple parts of the world…

As always, I remain open to comments, questions, answers in the form of publications and to the debate in general about what the life of an attending physician is like (because it is a special life whether you want to admit it or not…) and how it should be… OR CAN WE SAY THAT THE LIFE OF HEALTHCARE DOCTORS AROUND THE WORLD IS FINE????

Greetings… and thank you very much for reading the article!!!!!

F

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