When the Doctor Goes Home: The Coming Indifference of American Medicine

It is the close to midnight and your mother is drifting in and out of consciousness.  She is 77, not young but not old enough for fatalism.  In her darkened hospital room you feel fear and the dread of uncertainty.  And then, the doctor goes home.  In the New York Times, a recent article describes the migration of doctors from business ownership to shift workers.  In increasing numbers physicians are no longer entering traditional "private practice" but exchanging autonomy (such that it is) for a role as employee of hospitals, large "corporate" physician groups, or universities.  Most non-physicians seeing this change are reflexively sympathetic.  After all, "doctors are just like us," need predictable days off, personal days, set vacations, and the duality of rewarding home life and well-paying and ego-fulfilling job.   All that makes sense, until severe illness visits.  At that moment, in a hospital room at the end of the "second shift"...(Read Full Article)

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