What do you wish you could say to patients, but don't? "Try to understand what makes you healthy and unhealthy," says family physician Steven Horvitz, DO, in response to one of the 10 questions MedPage Today is asking healthcare professionals.
Horvitz owns and operates a family medicine practice in Moorestown, N.J., where he lives with his family.
1. What's the biggest barrier to practicing medicine today?
The biggest barrier to practicing medicine today is the third-party interference, whether it be from health insurers such as HMOs and PPOs or government regulations and mandates such as EMRs and HIPAA. A physician's No. 1 priority must be the patient sitting across the table. But with third parties whispering in your ears about this formulary or that pre-certification, it makes it difficult to focus solely on the patient.
2. What is your most vivid memory involving a patient who could not afford to pay for healthcare (or meds or tests, etc.) and how did you respond?
All physicians run into this situation. If a patient needs care they get it. We deal with getting paid, or not, later. There are many programs set up by pharmaceutical companies, laboratories, hospitals, as well as charitable organizations to help patients in need of care who cannot afford it. We try to steer these patients in the direction of the most affordable care or financial assistance. But as I stated earlier, the care comes first -- the payment, if any, later.
3. What do you most often wish you could say to patients, but don't?
I like motivated patients. I would like to say to all my patients that I want them to understand what makes them healthy and unhealthy, and not rely on a doctor or medication to fix them if they get sick. Physicians, especially in primary care, should teach their patients how to be healthy. I call this Wellcare instead of Sickcare.
4. If you could change or eliminate something about the healthcare system, what would it be?
Third-party insurance and government interference need to be greatly reduced so that physicians can do their jobs without having our hands tied behind our backs.
5. What is the most important piece of advice for med students or doctors just starting out today?
The healthcare system is changing. It is becoming a corporate- and government-controlled system. If that is what makes you comfortable you will get utmost satisfaction from being a physician. If you do not like the corporate world, beware, and develop a good business plan to allow yourself to succeed on your own.
6. What is your "elevator" pitch to persuade someone to pursue a career in medicine?
Healthcare is like an elevator. The amazing uplifting feeling of getting accepted into medical school, getting through the 4-year medical education followed by the 3 to 8 years of residency is amazing. It gives you an education and profession that will always be admired. But watch out for the descent!
7. What is the most rewarding aspect of being a doctor?
My most rewarding aspect of being a doctor is when new patients present to my office for evaluation and treatment after being referred by another patient. It is a wonderful feeling that all the hard work that went into becoming a physician earns you the respect of patients to share their health secrets with you.
8. What is the most memorable research published since you became a physician and why?
In general the research that has made the biggest impact on me and my practice has been about nutrition and disease. I am a big believer that the food you put into your body is so very important for optimal health. My practice puts a large part of our health and wellness counseling into diet and nutrition.
9. Do you have a favorite medical-themed book, movie or TV show?
There are plenty of ridiculous books, movies, and TV shows with a medical theme. That being said, I do still get a kick out of watching some medical television shows. Probably my favorite medical television shows were the earlier years of "ER." Much of the theme was ridiculous and would never occur in real life, but the show had characters that were about my age at the time so I almost felt like I had lived through much of what they were portraying on the show.
10. What is your advice to other physicians on how to avoid burnout?
Do not take patients problems home with you. As we all know, many patients agree with our advice in the office, but then fail to carry it through afterwards. Now, we are not always correct in our advice, but then again neither are the patients. Physicians must realize that patients need to take some responsibility for their own health, and work closely and honestly with their patients to have the best outcomes. So leave your worry and stress at the office. Don't live to work. Instead, work to live!!
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