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Doctors are not immune to the rapidly changing world that faces all of us.  The 21st Century has brought stunning changes to the world and to nearly every aspect of American society.  As a driver of change, the Covid pandemic was the cherry on top of the sundae.  Many doctors long for the world of the last century when they were highly respected, paid exceedingly well and were the masters of their practices.  Those days are long gone.

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The healthcare world is no longer controlled by doctors.  Instead, it is controlled by large health insurance companies, gargantuan hospital chains, Big Pharma, and private equity.  Doctors are just cogs in the wheel and they don’t like it.

Doctors don’t have the respect of the American people that they once had.  Can you imagine a time in the last century when people would be calling for the imprisonment or worse of the Chief Medical Adviser to the President of the United States?  The disrespect shown to Dr. Anthony Fauci was not limited to him alone.  Suspicion fell on every doctor who followed the science and urged masking, social distancing or any other change in behavior in response to the virus.

While most doctors will continue to be well-compensated (sorry, pediatricians), the big money is no longer there and won’t be again.  Although billions and billions of dollars flow through the health care system each year, most of it is siphoned off by the health insurance companies, Big Pharma, the hospitals chains, and private equity.  Doctors will have to accept these changes and get rid of their cherished “fee for service” model and embrace more efficient ways to get effective treatment to patients.

Eliminating “fee for service” may also help restore to doctors a measure of control over their practices.  Under “fee for service,” doctors have to push patients through the system rapidly in order to produce the volume necessary to generate substantial income.  Changing the model to focus on compensation based on good outcomes, for example, may allow doctors to spend the amount of time with each patient that the patient needs and that will produce a good outcome.

The good old days for doctors are over, although some future doctors may well look back on our time as the good old days.  Doctors need to get over it and adapt to the world as it is.  They need to earn back the respect of their patients and the public.