by Greg Singer, UMN Law Student, MJLST Managing Editor
The healthcare system in the United States is no stranger to debate. The current president won election, and recently re-election, due in no small part to his promises of reform in the area. It is no surprise that this is the case. People literally place their lives in the hands of the healthcare system, and utilize it so often that the combined spending on it consumes nearly 18% of the entire GDP (a figure that is only expected to rise as time wears on).
Yet anchoring the system that serves almost 315 million Americans is a surprisingly small contingent of no more than 960 thousand medical doctors (of whom only about 350 thousand are considered to be primary care physicians, and many of the remainder employed in non-patient-facing positions). This is an incredible burden placed on the shoulders of so few people, a burden that is only expected to become weightier in future years, as medical schools arguably fail to produce enough new physicians to properly care for the current set of patients, let alone all of the soon-to-be-patients as universal healthcare requirements set in pursuant to Affordable Health Care for America Act.
In Mistake-Proofing Medicine: Legal Considerations and Healthcare Quality Implications, published in volume 14.1 of the Minnesota Journal of Law, Science & Technology, authors John Grout, et al. argue that a significant portion of medical mistakes and errors may be attributable to a character flaw in the psyche of some physicians, specifically that they are beset with “a narcissism that blocks full acceptance of the notion that compliance rules apply to [them].” Moreover, the authors point to other character flaws, such as the performance of duties while under the influence and general substance abuse as significant causal factors for mistakes.
While these issues no doubt exist in one form or another, it is important to remember that the vast majority of doctors do try their best to help their patients. Given the unconscionable hours involved in the job, the relatively modest compensation for many, and the massive debt burdens required to enter the field, it is hard to imagine anyone, narcissistic or not, attempting it without possessing a truly real desire to help those in need. If anything, the simple exhaustion facing many doctors is a more understandable, and sympathetic, cause of error. Medical doctors are among the most overworked professionals in the United States, despite the extremely high stakes involved in their work. The high hours required is partly due to the culture surrounding the field, but the limited number of available physicians, despite the rising amount of time demanded by the growing lists of patients cannot be ignored.
Increasing enrollment in existing medical schools, or even creating new medical schools, may be a pathway to reducing medical mistakes errors, wait times, and perhaps even costs. But in the meantime, be understanding of your doctor. Do not immediately assume that his mistakes are due to arrogance or a flaw in his character. He may simply be tired.