Inside The Minds

Constant Change: Challenges and Satisfaction

Physicians practicing over the past several decades have seen

marked changes in the healthcare system and in the care of the
hospitalized patient. The passage of Medicare and Medicaid
legislation in the early 1960s first provided greater access to care
for the patients and better reimbursement for the physicians.
However, within the past 10 years these funds have retrenched to
the point that care has become threatened, and access to care will
surely decline for our elderly and less wealthy patients. Not only
have these funds decreased for physician payment, but hospital
reimbursement has also fallen drastically.

These factors effect not only patient care, but also medical
student, postgraduate, and specialty training. Moreover, funds
for basic and clinical research are severely threatened and
dwindling. The academic medical center, once the cornerstone of
innovation and discovery, as well as physician education, is now
threatened more than ever, and many of these institutions are
near closure. The American public expects the best medical care.
This includes new technology, new discoveries, and well-trained
physicians. No doubt in the near future a complete reassessment
of federal, state, private insurance, and managed-care funding
will need to be addressed in the face of decreasing care quality
and access. While physicians must keep abreast of all new
scientific findings, their judgment in the choice of treatment and
clinical activity may be altered by government regulations.
Physicians have lost a great deal of autonomy in treating their
patients.

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