A Voice for Frustrated Physicians

As individuals, and in health care organizations, physicians command respect and have a strong voice.

As a group, and in the health care system, the opposite seems true.

The science of medicine continues to advance. But the art of medicine — and the ability to prosper while practicing it — continues to decline.

We all know the problems: paltry reimbursement, myriad bureaucracy, insufficient time for patients, astronomical insurance costs, crushing debt for medical graduates. The list goes on. And so do the struggles.

Who would want to be a doctor, especially a general internist? These primary-care physicians tend to care for the elderly and chronically ill, and earn one of the lowest starting salaries among physicians. 

USA Today reported that only 2 percent of 1,177 respondents to a survey of students at 11 U.S. medical schools said they plan to go into general internal medicine. The long hours, lower income and grueling work deterred them. No wonder. Those already in practice may be having second thoughts.

My general internist recently was asked to leave a group practice. Why? He spent too much time with patients and it complicated reimbursement. He's cared for me over a decade with insight, skill and remarkable dedication. But that's not how medicine is practiced any more. So, he's worn out and frustrated. And he's not alone.

I'd say doctors are mad as hell and they're not going to take it anymore. But they haven't really flexed their muscle because they've been unable to unite with a single voice in real time—until now.

Since July, more than 7,300 of the nation's 600,000 practicing physicians have signed an "Open Letter from America's Physicians," a manifesto for change. They've come together on Sermo, a physician-only online network that boasts a membership of 70,000 doctors.

Sermo was designed for physicians to exchange clinical insights, review cases, influence the biopharmaceutical industry and help improve patient care in real time. Now it's giving doctors a unified voice. (See www.sermo.com/doctorsunite)

Online grassroots movements can erupt with great power. Let's hope this one gathers momentum. Sermo is Latin for "conversation." That's the first step toward abeo, Latin for "change."

— Tom DeSanto