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Metrics over Medicine: A Physician’s Defiance Against a Dysfunctional System

Mona Amini MD, MBA shares a narrative — a tale of broken promises, moral dilemmas, and the private battles with burnout and injustice that shadow the corridors of American healthcare.

May 1, 2024

I’ve been diagnosed with cancer, months before graduating from residency.

I’ve engaged in earnest discussions with Chief Financial Officers to advocate for improved and competitive compensation, particularly in mental health settings that are historically challenging to staff.

I’ve been instructed to immediately dedicate time during a family holiday weekend to accommodate leadership’s request for a Zoom meeting, with the purpose of reviewing and evaluating a mobile app, despite the project not having an immediate deadline.

I’ve endured embarrassment of being given one promise as a C-Suite member but upon time to deliver (and after making such goals) was told the metrics changed and were unmet due to these additions.

 

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I’ve been asked to consider taking no pay for an indefinite amount of time as a physician with an overwhelming amount of medical school student loans due to failures in the local healthcare payor system.

I’ve witnessed and experienced poor quality of care being delivered with the inability to make a change due to excuse that “healthcare systems are in place.”

I’ve been told that the focus on quality of care is downstream – let’s shoot for the numbers first.

I’ve encountered significant resistance from colleagues who remain hesitant to embrace the innovative approaches that are essential for transformative change.

 

The message from above was clear: prioritize numbers over quality, shatter boundaries, and work for a system with the disheartening directive that undermines our oath to provide the best care possible. As an advocate for mental health, it’s unnerving to find oneself isolated among peers who lack a vision for innovation.

This reflection offers a glimpse into the obscured realities faced by physicians, revealing a dichotomy that forces a choice between upholding our ethical standards and succumbing to the pressure of metrics. The two should not be mutually exclusive.

 

The message from above was clear: prioritize numbers over quality, shatter boundaries, and work for a system with the disheartening directive that undermines our oath to provide the best care possible.

 

We work in an industry where compensation follows service, yet payment is not guaranteed.

When facilities fail financially, the burden falls on healthcare providers, who may then face exorbitant legal fees to seek what is rightfully theirs — a burden few can afford.

When taking your car for service to your local dealer and are unable to pay the invoiced amount, you don’t take your car home. Evidently not the case in healthcare.

The time has come for true leadership in medicine, led by those who actually respect their team’s well-being and recognize the alarming rates of physician suicide. After years of cultivating expertise and empathy, it is devastating to be undermined by the very system we aimed to serve.

 

After years of cultivating expertise and empathy, it is devastating to be undermined by the very system we aimed to serve. Click To Tweet

 

It is not my intention to diminish our collective efforts; rather, I aim to shed light on the unseen struggles of healthcare providers. We are individuals fighting against professional and personal burnout, striving to balance our lives while facing increasingly relentless demands with stagnant rewards.

No, our generation is not “weak”. We possess a resilience that is often understated.

We have withstood an unprecedented confluence of societal and economic challenges that are unique to our time.

It’s imperative that we seek to understand these pressures and work collaboratively towards meaningful and lasting solutions.

The call for change is urgent, not just for the healthcare system, but for the well-being of those dedicated individuals at its core.

Mona Amini MD, MBA

Mona Amini MD, MBA

Dr. Mona Amini: A luminary of visionary spirit and empathic excellence in psychiatry, transforming care with innovative grace.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. For more information, or to submit your own opinion, please see our submission guidelines or email opmed@doximity.com. Do you have a compelling personal story you’d like to see published on SoMeDocs? Find out what we’re looking for here and submit your writing, or send us a pitch.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. Do you have a compelling personal story you’d like to see published on SoMeDocs? Submit your own article now here.

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