BY SCOTT MACDIARMID

We have a healthcare crisis . . . and the crisis is now. Costs are soaring out of control, threatening the financial health of individuals and our nation. Quality of care is deteriorating, in spite of “world class care” signs seemingly on every corner. And physicians are checking out and burning out. I believe it’s one of the greatest societal issues of our day.

So, you may be wondering: How in the heck did we get ourselves into such a mess? In the greatest country in the world who spends the most on healthcare and is regularly bragging on how great it is, what happened? 

Experts and pundits alike tout a litany of reasons. Increasing life expectancy, our reliance on sophisticated and expensive diagnostic tests and treatments, the costs of big pharma, duplication of care, fraud and abuse—the list goes on. Although these are all important contributors, none of them points to the underlying disease that’s killing healthcare.

The healthcare system in some respects is like the human body. It has seven systems, and the health and survival of each is largely dependent on the health of the others, much like the inter-dependent relationship of the organs of the human body. For example, if your liver or kidneys fail, your body’s health is severely impacted, even if your heart and lungs are functioning normally. 

The seven systems of healthcare include the patients, the physicians and other providers, hospitals, third-party payers, the manufacturers of drugs and equipment, the legal profession, and the government. For the body of healthcare to be healthy, all seven systems must be in order. 

Unfortunately, we have over-corporatized the American healthcare system making healthcare a commodity. And the problem with it being over-corporatized is that its seven systems are infected with the greed virus. Yes, the disease killing healthcare is greed, and it has infected people and corporations. A rapidly spreading infection of greed, entitlement, and unrealistic expectations. Unfortunately, it’s human nature.

For decades, each system has been taking as much as it can, as fast as it can, and its insatiable greed has spread out of control. It’s not sustainable. 

Insurance companies raise premiums by double digits while denying coverage. The pharmaceutical companies charge astronomic prices for insulin, chemotherapy, and many other life-giving drugs. Attorneys win multi-million-dollar settlements and drive regulatory costs skyward. Hospitals make millions while hiring less qualified nurses. Government officials swayed by corporate lobbyists tout that they care about the cost of healthcare. Physicians commoditize patients by performing unnecessary tests and procedures. And patients want perfect healthcare and they want it now. Everyone’s been taking, and the system is dying. 

The greed virus impacts each system differently with winners and losers. The Wall Street players in medicine—those corporations that make the drugs and equipment, the hospitals, the legal profession, and the insurance industry—are doing great. While the Main Street of medicine—the physician, the nurse, and the patient, or what I refer to as functional or day-to-day healthcare—is getting hammered. Physicians and nurses are overworked and burned out by the demands of the medical-industrial complex that requires they spend less time with patients who need them more.

The body of healthcare is desperately ill and it represents one of the most important societal issues of our day. Greed is the fundamental problem and it’s driving up costs, driving down quality, and burning out its providers. And as it did in the greed-infected financial and banking industry, the system is destroying itself.   

This is what happens when you commoditize healthcare and stray too far from its fundamental role in society. Healthcare is a basic need of every human being. But when healthcare becomes a commodity, the greed virus spreads, the end user suffers, the body dies, the greediest make millions, and provider burnout is everywhere. 

Potentially lethal, the greed virus must be eradicated. The health of the body of healthcare and our nation depends on it. And with the majority of us sharing some culpability, we’re all responsible for its treatment and solution. We’re all responsible for the health of the nation. 

In Fist pumps… The Prescription for Physician Burnout, we visit with the greed virus and how it infects each system in the body of healthcare resulting in physician and provider burnout. The book teaches us to effectively manage the virus and provides numerous battle strategies enabling us to be a great warrior in our battle against burnout. 

Putting on your suit of armor is to know your purpose, is to know your why. It’s to understand what you’re here on this earth to accomplish. It’s to make mountaintop decisions and to make them several times daily. In the deepest of contrasts to the valley of burnout, the mountaintop is that sacred place where you find joy, peace, virtue, and contentment. 

Fortifying the homeland by building a workplace that inspires you and makes you feel safe is necessary to ward off the attack from external forces. The importance of leadership, safety, empowerment, accountability, communication, and providing necessary margin is emphasized.  

Many physicians live their lives out of balance. By rethinking the battle they realize that feeling fulfilled in life primarily through one’s job is not a good strategy, as opposed to seeking fulfillment through multiple life domains, like family, friends, physical and mental/spiritual health, and community. Every decision you make to serve others in all life domains, whether small or large, will shape and define your mountaintop of joy and fulfillment. 

In my struggle, I realized that the primary battle against burnout was not with my circumstances, with my patients, or with commoditized healthcare, which are generally ongoing and unchanging. But that the true battlefield where the most important battles are won or lost is in my mind. The battle is in my thoughts and how I choose to think from moment to moment. 

Fist Pumps discusses numerous ways of thinking that help produce healthy emotions, words, actions, and a meaningful life. It teaches you to have a mind of a warrior equipping you to prevent or to battle burnout. In order to have a warrior’s mind, you first need a warrior’s heart. The heart of a warrior is a heart of love, gratefulness, forgiveness, humility, patience, and self-control.

“Self-help” was purposely included in the subtitle of the book, because it’s the person you see in the mirror who ultimately holds the solutions and survival tactics to your own success in dealing with the greed virus. Self, when combined with commitment and hard work, is the prescription for burnout.

Dr. Scott MacDiarmid is an academic urologist practicing in North Carolina whose passion and lofty goal is to create a world that lifts up physicians and healthcare providers who serve.