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Spokane, Washington  Est. May 19, 1883
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Dr. Susan Hecker: Business approach replaces practice of art in medical field

Dr. Susan Hecker

There is a crisis in primary care today. All too often, the usual culprits are blamed: providers retiring, more patients have insurance, medical schools are not training primary care providers. These issues are important, but they detract from the core problem: why physicians cannot be recruited and retained in primary care.

I am an internal medicine physician who truly enjoys primary care. It is my passion. I was trained at the University of Washington, which strongly emphasizes careers in primary care. There is a shortage of internists, locally and nationally. I left a higher-paying job to become a primary care provider. And now I am leaving.

I am leaving because the system has forgotten that true medicine incorporates both science and art. In my short time as a physician, I have realized that the art of medicine is just as important, if not more so, than the technical aspect. The technical aspect saves you from imminent death, but it also interferes with a good death. It is a skill that is needed during a particular time, but should be left when no longer necessary. The art of medicine, where true healing occurs, is relegated to an ugly stepsister status, not felt to be worth the time of more cultured civilians.

Our current system ignores the creativity of medicine and insists on treating the patient like a machine with parts that need tweaking. Time with patients is limited; physicians do not have the luxury to allow a patient to tell their story and extract the history from there. They are told how many patients to see and how long it will take regardless of the patient’s need. One cannot listen effectively when on a tight schedule. Limited time results in questions asked in a yes-or-no fashion that miss the nuances. Limited time leads to divided attention, resulting in patients being less likely to divulge important and necessary details.

Patients recognize that the system has abandoned the art of medicine and have voted with their feet. They have moved to other realms of medicine that focus on this aspect more so than just the technicalities; chiropractors, naturopaths, acupuncturists. Yes, patients want technically sound care. But, even more so, they want someone who will listen, understands their concerns and develops a plan of action that directly addresses these needs.

I did not go to medical school and sacrifice seven years of my life after college to push people through like parts on an assembly line. I went to medical school because I had a passion for serving others and a desire to make a difference in individual lives. However, business efficiency has replaced the effectiveness of human relationships. In both direct and indirect ways, I am told daily that only efficiency matters. I can stay and become angry, inattentive and ineffective. Or I can leave. I have chosen to leave.

Susan Hecker is a Washington native who graduated from the University of Washington School of Medicine in 2007 and completed her internal medicine residency at the University of Utah in 2010. She will continue practicing medicine at a local nursing home as its full-time nursing home specialist.
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