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Tired of ‘Color by Number’ Medicine? Here’s One Physician’s Advice

Note: Guest blogger Mark Matta, DO, is a psychiatrist from New Castle, PA, and a PAMED member. Hs is president of Psych-Med Associates, P.C. , and medical director of the Department of Psychiatry at UMPC Jameson.

The U.S. is facing challenges seemingly on an hourly basis on a number of political, economic, and health care related issues.  Perpetually lost in the mix has been the mental health patient. 

 

Mark Matta, DO, was one of the winners of PAMED's "Top Physicians Under 40" Award in 2016. You can find out about the other 2016 winners and nominate a colleague for this year's award here.

As my career advances, my mind not only becomes more frustrated by our barrier system, but my heart also aches for those who suffer the consequences.

The inpatient behavioral health unit in my local community hospital recently closed after serving the community for more than 50 years.  Now the patients will be transferred out to between 30 and 90 minutes away from their residence to receive acute mental health treatment.

My fear has always been that these patients may act out rather than go through the laborious process of an ER transfer. Likewise, continuity of care has been lost as family meetings cannot be easily conducted and the psychiatrists rounding on the patients are less familiar with them.

The opportunities for me to practice inpatient psychiatry are coming from the same distances rather than in my own town. Medicine has become makeshift, and I believe it has affected its overall quality. 

In my training, one thing I learned to appreciate above all was that medicine is an art. What once was a blank canvas with an endless color palate at our disposal is rapidly becoming a practice of coloring by number.

So what can be done?

How do we, as physicians, recreate what once was? I for one resist the trend as much as possible.

For instance, the insurance companies often utilize FDA indications to authorize or deny treatment for conditions. There are many times when an illness does not have a single medication indicated for its treatment. At that point, what is a clinician to do?

There may be evidence in the literature of the medication being utilized in off label conditions without an absolute indication. Therefore, we need to be up to date on the latest trials to know how best to engage an authorization battle. Understanding how to use the medications in the best interest for our patients is essential to their wellbeing and is part of that artistry.

Another area we can improve on is advocacy for our profession.

Physicians notoriously are not good at fighting for ourselves. I believe that is a large reason why we are in our current model of medicine.

We have allowed others to make health care-related decisions because overnight it became a business.  While we were spending a decade or longer learning our craft, others were learning how to mold the money from that craft.

Now, we are playing catch up. Enough is enough.

Let us take back what is rightfully ours. Let us fight the good fight. Let us become satisfied in our careers once again. 

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dlaldinger2

I totally agree. Medicine is now run by insurance companies, government, and administrators/be auroras

Sunday, February 19, 2017 4:01:15 PM

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