I'm watching it, I'll let you know what I think, but I don't think it brought up any new information. Also, since it is a Grand Rounds presentation by a resident, it strayed into the usual "I'm making jokes, look at me" territory. (Around 7:00, where he starts joking that one of the residents in the program was Hootie from Hootie and the Blowfish and another resident was a YouTube singing sensation.) I could do without that stuff.
Further into the video, we get the body of the presentation, that surgeons are increasingly burnt out due to loss of autonomy (from bureaucracies and also mandates forced on us from Medicare/Medicaid) and (the lack of) tort reform. The problem is that, with or without Obamacare, those remain. What I have always said is that we're fighting a losing battle because the left has ingrained into the current generation, even physicians, that healthcare is a "right." It's not, it's a service provided by people and those people are not slaves. But when faced with Obamacare, our options are either Obamacare or the current system. And the current system (pre-O-care) is already problematic. We already have healthcare controlled by the government. I'm not saying, for example, that UTIs are "good" by any stretch, but the fact that Medicare can just say "oh, UTIs should never happen and therefore we won't pay for any UTIs or urosepsis or pneumonias, etc, etc" is ridiculous. That's some bureaucrat who never had to take care of a patient sitting around who decided that all he has to do is take away our money and we'll snap to it. My response would be to just dump all Medicare patients. Let him take care of them. I have better things to do than get reimbursed pennies for my work with increasing amounts of paperwork and delayed payments.
The reality is that what has destroyed our system is the government promise to everyone that everyone gets everything. We've all heard ad nauseum about the families who keep their elderly demented parents trundling between nursing homes and the hospital, often the ICU, who want "everything done" because they pay for practically none of it. And we all demand that now. And as a result, healthcare has skyrocketed. Contrary to popular belief, it's not "impossible" to pay for your own healthcare, but who wants to pay a few thousand dollars for your appendectomy when you can get it for free, ostensibly? That would be a sucker's proposition. Or how about the fact that we spend the bulk of our healthcare dollars on people in the last month of their life, just to say we did "everything" to prolong it? Everyone is afraid to tell people flat out "this is futile care and I'm not participating in it" because then you're the mean physician who didn't care. And don't get this confused with Obamacare, where people are just told "you don't really need a pacemaker" simply on the basis of their age. I'm talking about literally futile care, and if anyone can't tell the difference then I suggest you immediately stop practicing medicine.
We won't get back to free-market medicine because people demand all the latest tests, every bit of labwork. And they won't pay for it. People are ignorant. How many of you have had a patient say "I'm not leaving the hospital because what if I have to come back?" Now, I'm not saying they're bad people for saying that. I'm just saying they're ignorant. And they can do that because they don't pay for it. Can you imagine telling a hotel that? "Oh, I just don't feel like leaving today, come back tomorrow and I'll let you know." And guess what? Half the time, we just let them languish because it's easier and we don't want to anger anyone! Ridiculous.
Combating that mentality of entitlement is the main thing we have to do, and it won't work because we will get tarred as being "uncompassionate."
