The Black Hat thinking Attitude is not working in Favor of Physicians, after All!
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In general, and by nature, physicians are Black Hat thinkers because they tend to stare at a decision’s potentially negative consequences before they embrace the opinion. Physicians are always cautious and defensive with every judgment they come up with, merely Trying to see why it might not work. They simply highlight the vulnerable points in a blueprint, providing the opportunity to eliminate them, alter them, or prepare contingency plans to react to them. The physician black hat attitude only goes so far, as policies and bureaucracy ultimately prevail over physician decision-making style. The latter is the prerequisite to what we call chronic naggers or complainers amongst physicians. Physicians are complainers. They are profoundly distressed by healthcare problems that they feel powerless to improve. They feel simultaneously irritated and unhappy about their work condition and worry that it is their fault if a patient does not receive the care they need. Furthermore, they do not know how to reassure themselves. Physicians sense the Healthcare Problem before delivered to Patients Physicians and other healthcare experts alike are at the front line of medical care to their patients. It is just like knowing the negative outcome of a policy and how it will affect the quality of medical service they render before that policy is put to work. Such a position is the upshot of Black hat thinking. Nonetheless, policies and procedures funneled by non-medicals and politicians place the physicians in an awkward position; that is, take it or leave it! But physicians have obligations to their patients. That obligation will typically take the extra step to circumvent the negative consequences of some of the wrong policies brought up by faulty decisions. Generally speaking, Physicians by trait have been passive when it comes to administrative decisions because politicians and administrators are challenging, if ever, black hat thinkers. Their attitude is to focus on the possible alternative options that maintain public support. The latter places them at a much higher advantage over the physicians.
The Majority of Physicians are Complainers
The combination of Black hat thinking attitude, commitment to their patients, and passivity in response to administrative decisions has created a new behavior in the physician community, that is complaining. But complaining goes so far and gives the impression to focus its positive outcome on the individual physician vs. healthcare. At the very least, that is what Dr. Abe Kashani speculated on his blog in 2014. According to him, one can see four reasons why doctors who protest are those who become successful. First- because complaining implies that physicians are actively acknowledging that there is a problem with the prevailing circumstances. Second- by opposing, they tend to express that they have enough self-esteem to feel that they merit better options. Third- those who complain are trying to show that they are not hesitant to express their dissatisfaction. And finally- physicians see Complaining as an indicator of urgency for reform.
Kashani assumes passive doctors are inadvertently drifting along with the stream. The complainers always find the flow impediments to getting ahead of the rest of the medical community.
What Dr. Kashani is implying summarizes the nuts and bolts of how physicians are and what delineates the individual physician’s success. His vision also points to the same, Black Hat thinking trait that physicians typically possess. Furthermore, passivity and any given physician’s activeness is the upshot of the balance of power between which direction that physician should proceed. The passive may simply be the burned-out physician who kept trying to deliver top-notch care to their patients but couldn’t sustain it any longer. Whereas, the active complainer may be the one who finds the opportunity to use the system to their benefit, irrespective of the effect that decision would be having on the patient care. The Patient-Centered Physician will Burnout while Complaining!
Physician Burnout remains to be very high, according to a 2020 report. The majority of physicians feel overly pessimistic about any future improvement. Of all the physicians surveyed, 42% felt burned out. According to a survey published by Medscape, independent physicians might experience less burnout because they are in charge of their workload. Fifty-five percent of physicians alleged they had to cope with excessive bureaucratic responsibilities, while 33% held they were spending many of their personal hours at work.
Long periods, workload, and a dearth of support have unswervingly outranked as the top contributors to physician burnout over the last decade. More than 60% of physicians said they do not plan to seek help for their burnout or depression. About half said their symptoms weren’t severe enough when asked why, while others responded that they could deal with their burnout without professional help or were only too busy.
Once again, physician burnout is a symptom, and not the disease, per se. It is the product of a responsible and good doctor rewarded for his or her “Black Hat thought process” with an unclear destination. Despite all said, all they can do, at best, complain. But is complaining about going to help?
Physicians have become a Profession of Whiners
Doctors are becoming more than ever recognized as whiners. Those who have met physicians in meetings, dinners, parties, social media, and doctor lounges have probably noticed how much time they spend the day in and day out complaining about extended work hours and workover loads. They continuously criticize the system and even try to discourage the junior from pursuing a medical profession. The mainstream physician community is riddled with the bulk of upset voices indicating that modern healthcare is a monster, even though they want to help and practice what they know best.
Physicians Whine strongly acknowledge that despite the need to refurbish and repair significant parts of healthcare, many change elements imperil the ability to interact with patients and disrupt the physician-patient relationship. Physicians don’t justify themselves. They do not rant for treasure or personal distinction, but for those who trust their parties to the medical service.
Complaining won’t Solve the Healthcare Problem
We have some serious problems concerning healthcare, but complaining isn’t going to help. We have to be a part of the solution by disassociating ourselves from the situation and stop complaining.
Physicians appreciate what they need and want from their professional life. There are some areas and solutions that they disagree with and can’t help complaining about. However, the state of healthcare is not how it ideally should have been. Complaining won’t remedy anything to the ongoing healthcare problems. And indeed, passivity is not the answer either!
You may think complaining is just venting off, serving as an opportunity to let out some steam. But it has much more unfavorable impacts on the system as a whole and can be soul-draining for anyone who receives it.
Physicians Blame Healthcare Technology
We have been lamenting about the interruption that technological mandates have brought to physician practices in the recent decade. But technology can leverage doctor’s practice only if used in the right way. According to a Study Physician, Burnout seems to correlate with Electronic Health Record Usage (EHR) directly. Forty percent of physician burnout is attributable to EHRs, up from the previously estimated 13 percent. That is why powerful technologies like EHR have met with many criticisms from physicians, some of which turn out to be accurate. With the advent of the Merit-based physician reimbursement, a medical record that used to be a few lines to document now may be over two pages long. That is even more stressful when the time allowed for a patient visit as being the same, if not lowered to 15 min.
In 2009, when the HITECH (Health Information Technology for Economic and Clinical Health) Act was enacted into legislation, EHRs were reckoned to lessen administrative burden, lead to more cost-effective healthcare, and reduce paper waste. But so far, it hasn’t. Instead has created more physician whiners.
The Black Hat physician attitudes have not worked in their interest in information technology. Instead, it has created a vacuum for other industry impresarios, information, and the insurance industry, significantly to meddle in the healthcare realm. Doing so has uttered physicians’ taking a follower stance rather than a leadership role, just if physicians should assume the pre-programmed algorithms. That is why the use case of the common Electronic health records is not in line with physician practices.
The role of doctors traditionally has been standard in their profession to use their skills to treat patients. The doctor-patient relationship was one of the most fundamental aspects which stood the test of time. But many powers in the 21st-Century realm are seeking to disrupt the doctor-patient relationship. So being critical by default will not benefit the physicians and surely won’t help the patients. Modern doctors must shape themselves as significant-concerning fundamental to improve their understanding of the essential technologies during the phase of evolution. Such a process should start in the medical schools to become adept in handling the technologies right from the beginning of their practice.
The doctors’ skill has to be coherent and rapt in the right path for creating the right implement that will aid domains healthcare alike.
Physicians Blaming the Healthcare Policies
As large healthcare systems and medical cultures attempt to address physician burnout, much of what they indorse eventually lays the burden on physicians to fix the problem. Implementing team-based care to time investment, peer support, and introducing more mindfulness into practice only displaces physicians’ responsibility from one form to another or simply swipes it under the rug. That is the reason why physicians typically complain, and policies hardly solve their problem.
Today States have taken upon themselves to regulate numerous aspects of healthcare logistics from financing, assembling the necessary means through public funding, pooling resources, and overseeing the process of resource allocation. Such substantial involvement of the administration in the healthcare affairs has made the core players of the healthcare system dependent on their officialism exploits. That further alienates the patients and physicians from the vision and mission of genuine healthcare. Such capacity is personal as the healthcare system is constrained to the corporate lobbyist efforts and exclusive war amongst various factions. It will indeed be adversely affected, based on political affiliation rather than patient-focused tactical missions of healthcare scholars, further estranging the medical professionals.
Indeed, physicians are correct when they blame the policymakers for the wrong decisions they make. For instance, the Affordable Care Act (ACA) turned out non-affordable care for those intended to serve. It raised deductibles and opened the door to surprise medical bills. Likewise, ACA didn’t turn out to be beneficial for independent physicians. Also, the money that is going to the healthcare system is not producing the coveted quality.
Physicians know that healthcare is not just about mandating and expanding coverage. And that they cannot improve healthcare quality by spending increased amounts of money or by raising taxes. The medical community can’t afford to depend on Non-Medical Personalities for Intervention. Then again, complaining is not reducing the healthcare burden. Wrong policies are the upshot of doctor alienation from the administrative arena. Their estrangement is the symptom of their passive Black Hat attitudes that hinder them from taking embracing actions. That means some decisions are intended to be made based on the principle: “Choosing the best option we have for the time, rather than waiting for the best solution to knock our door so we can support.”
Physicians Fault the Insurance Industry
There is no doubt that the insurance industry and their pharmaceutical counterparts play a significant role in healthcare costs, how much physician reimbursement should be, or what services patients are ought to receive. Then again, we often overlook the fact that the insurance industry is not a welfare organization. It has never been and will probably stay that way. So, blaming the insurance industry is just as if one indicts the lawyer for charging hefty fees for services they render or a physician billing a patient for a procedure performed. Maybe it is time for physicians to support patients to take a proactive role in engaging the competitive market.
Population Health, 21st-century and Physician Burnout
Evidence-based medicine utilizes randomized controlled trials and meta-analyses as powerful tools and confirmation sources about mediocre results for various patients. They are developed as response versus poorly designed observational treatment research and physician reliance on personal experience with other patients to guide decision-making about a patient at hand. Notwithstanding, these instruments help physicians question the therapeutic regimen customized for every patient at a given point in her/his clinical course. Until not long ago, that problem was not of great concern since technology and science were in their fancy stage. Furthermore, the general public’s expectation was not as developed, given relatively limited access to high-quality information. However, with ever-evolving technological advances, patient expectations parallelly grow, demand for more personalized care intensifies, and population health flunks to provide answers to the individual orders.
Physicians work harder to fill the gaps in patient expectations and experience, but they can only go so far. In other words, clinicians, and specialists, physicians centrally concede that data and evidence-based support improve patients’ health and survival. Yet, comparative-performance reports generate unhappiness and resentment, clashing with traditional medical culture by rifting between what the reports highlight and which perspectives of medicine doctors value most utmost. Hence, the increasing discrepancy created by that rift is a significant contributor to physician complaints, burnout, and passivity.
It is imperative to realize that personalized healthcare in the 21st-century medical domain is necessary rather than an option or a complementary service. However, that can never be implemented if physicians continue the path of whining rather than self-reform.
Value-Based Care and Physician Dissatisfaction
One of the most hypocritical undertakings of the modern healthcare administrations is implementing a value-based reimbursement system amid maintaining the population health scheme. Because value and quality are relative traits of a service delivered in a personalized environment; otherwise, such a deal can only be an outcome of a fictitious metric system. It focuses on cost control and a set of statistically driven social determinants of health and disease. Value-based reimbursement demands extra effort from physicians adding the further reason for the already burning physician to complain.
Physician Decisions also affect Patient Care Quality
Every physician understands how tough his job is- and the resulting burnout it can cause. Long hours of work, the burden of student loans, administrative pressure, compliance issues, and other factors leave physicians depersonalized, exhausted, and with decreased efficiency. That can feel natural to vent about burnout, but it will keep hurting if they don’t do anything about it. Physicians cannot merely change the external factors accountable for their frustration and burnout, but they can change the practice’s nature. They need to adapt to technology. The attitude of defying technology, kicking the can of policies down the road of politics will not help them in the long run. You have to begin somewhere and slowly. Only then can we expect the external factors to change!
We need to understand that healthcare consists of multiple aspects like quality of care, supervision, information management, patients, providers, expenses, interdisciplinary interaction, and influenced by social perceptions and socioeconomic conditions. Unless we can create a balance, we won’t have harmony within our professional lives and only keep complaining!
We can make things more straightforward, transparent with the right solution. It won’t work like magic, but we can start someplace. We should begin by developing an open and free healthcare market where healthy competition can flourish. Within such a system, every individual should be able to have the opportunity to make an informed judgment based on awareness generated by healthcare services and governments. Practices like the population-based model tend to overlook the personal needs of the patient. The model is aimed at a population with lesser awareness and education. But in the age of the internet and information, patients have become more knowledgeable. Personalization enables patients to get what they need and physicians to follow what they want instead of establishing norms. Staying healthy is an individual right, and that makes it a personal choice to stay healthy. We can solve many of our performance and efficiency problems by bringing in personalized healthcare to every human being.