Baird Brightman, PhD’s article published December 23, 2019 really hits home.  I’ve been trying to deal with the loss of my practice and the systematic destruction of medicine as a whole.  Dr. Brightman’s insightful article has helped me understand what I am dealing with.  By clicking on the title of this article, you will be transported to Dr Brightman’s article.

In the past, I wrote about “AI” and its new place in the medical world.  For those of you that missed the article, “AI” is Artificial Intelligence. For years, doctors have warned the public, government and insurers about an impending shortage of primary care physicians.  That shortage has arrived!  On a daily basis, I hear from patients who can’t find a new doc.

I now believe that the shortage plaguing my patients was no accident.  Many of my colleagues and I spent the last 15 years fighting the insurers, PBMs and government on behalf of our patients.  We did not enjoy the fight.  We did not profit from fighting.  We had a sacred responsibility to care for our patients and put their needs above all else.  That relationship has killed the practice of medicine.

We, as a once powerful group, cost the insurers, PBMs and government a lot of money as we jumped through hoops getting approval for testing, medications and necessary procedures for our patients.  Slowly but surely, our power diminished.  We were demoted from physician to providers.  We were forced to accept treatment guidelines as law.  We were accused by the media and government of “fraud and abuse” which supposedly runs into the hundreds of millions of dollars.  The latest assault on physicians, as a whole, has to do with the “opioid crisis.”  Is it any wonder that people no longer want to go into primary care?

In a recent article on the net, a physician pointed out that, in the future, nurse practitioners (NP) will be referred to as “advanced practice providers.”  Physicians will still be referred to as “providers.”  Doesn’t it sound like an “advanced practice provider” has more training and experience than a lowly “provider”?  

I have trained nurse practitioners and physician assistants for years. I have been impressed with their capabilities and dedication, but they are not physicians.  Their training falls far short of your physician’s training. In the beginning, their licensure required that they be supervised by an M.D.  Those requirements are vanishing.

A recent article noted that 60 physicians employed by a local hospital conglomerate were fired and replaced by NPs.  Why?  The answer is simple.  NPs cost less than MDs!  Are you wondering what my point is? 

“AI” is cheaper than physicians, NPs, and PAs.  “AI” will not form a sacred relationship with patients.  “AI,” at least for a while, will obey the rules. It will not argue over a denial of services.  Google will become your provider and the younger generations will be happy to accept Googles advice[rS1] .

I’m actually scared!  Our upcoming move to North Carolina means that Renee and I need to find new docs.  That’s not going to be easy.  We are on Medicare which pays poorly.  I am sick, requiring multiple referrals which will mean extra hassles and expense for any doc who takes care of me.  I’m on multiple meds further complicating matters.  I also want a physician who will be caring, attentive (listen to me), and available when I need him/her.  My patients are telling me that such a person no longer exists.

If I’m scared despite all my knowledge and experience, I can’t imagine what you are going through!  Again, I’m sorry I had to leave you when I did.


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