I've spent a fair amount of time over the last few years attending various medical society meetings. We talk about lots of things, but the overarching them usually seems to be "how to fix our broken health care system". There are many reasons the system is broken, but usually the discussion has to do with reimbursement and how there just plain is no way the current rate of growing expenses can be sustained in our society. Too many uninsured, too many frivolous lawsuits, too many primary care providers fleeing to higher-paid specialties.
This has never been so strongly impressed on me as during my current rotation. I'm doing general internal medicine (primary care) and the team I work with has traditionally made this one of the easier rotations of the year. Too easy, as it turns out, so the program director completely changed the system earlier this month (right after I started) so that I carry 3 to 4 times as many patients as the interns on the other team. I have so many patients, it turns out, that I don't have time to really spend more than a few minutes with them. I can't get to know them or follow up with them several times a day. I can't really care for them like I should. I spend my day running around frantically trying to get all the busy-work and paperwork out of the way. I dictate, review lab results, and chart my little heart out. I've got 20 years of education to be a specialized secretary, it seems. And the patients suffer.