More and more physicians are no longer sitting by and allowing administrators to devalue patient care and set artificial metrics for quality of care.  Quality of care now, is measure by the number of boxes checked of in an electronic health records.  Simplistic measures such
Sickcare is sick and innovation can help make it more like a healthcare system. Forces are already in play making that happen, but it will take a substantial effort still to achieve a more cost-effective, user friendly and efficient system. Overcoming the political, economic and cultural barriers of government, academia, business and sick care is indeed a Herculean task. 

Trump's policies are pressing doctors to speak out

ACA repeal efforts and other Trump administration policies are getting unprecedented pushback from the medical community.A lot is on the line. The House has passed legislation to replace the ACA in the American Health Care Act (ACHA), and the Senate is working on its own repeal bill. Funding for women’s health programs and protections for people with preexisting conditions are at risk of being cut or eliminated. The president’s budget would slash Medicaid by more than $600 billion. And Trump’s executive order on immigration threatens to curb the supply of foreign doctors.Doctors are speaking out against the administration's policies in public media, in protests, through petitions and in direct conversations with lawmakers, either in Washington or during town halls in their districts. For the most part, their employers support them. Doctors are careful to separate their patient contact from their political activity, but many view protesting as not only a right, but also an obligation.

In an opinion piece in the Washington Post, Dr. Dhruv Khullar urged Congress and the White House to ensure that no one with health insurance today would lose coverage in the future. “My patients can’t wait for policies that appeal to this political lobby or that political base,” he wrote. “Any lapse in insurance coverage affects the care they get — or don’t get — First do no harm

Doctors must toe a fine line in balancing political advocacy and their responsibilities to patients.

The American Medical Association’s (AMA) Code of Medical Ethics encourages doctors to “stay well informed” about proposed healthcare policies and “work toward and advocate for the reform and proper administration of laws related to healthcare.” However, it draws a line against mixing politics with patient care. According to Section 2.3.4, physicians should “be sensitive to the imbalance of power in the patient-physician relationship” and “refrain from political conversations during the clinical encounter.”

The American College of Physicians (ACP) encourages its members to take a stand on issues affecting healthcare. “We have been advocating very, very strongly in support of the ACA and against the AHCA,” Dr. Jack Ende, president of the ACP, tells Healthcare Dive, adding that the college focuses on policies and not political parties or politicians. “If the evidence shows that the public is better served with one program, that’s the program we support,” he says.There have also been turnouts at GOP town hall in support of the Affordable Care Act and callers expressing concerns about HHS Secretary Tom Price’s ties to healthcare companies. The public outcry puts businesses in a bind that ultimately just want to make money. Hospitals and health systems now have to consider their brand under the Trump administration.While health systems and other employers typically refrain from activism, most seem to support medical professionals’ right to protest policies they feel harm patients, so long a they do it on their own time.Care through a broader lens

For many physicians, the Trump era has sharpened the realization that staying in their office isn’t enough and that larger contextual issues play as important a role in a patient’s health as the treatments doctors prescribe.To influence the debate, Chhabra and some colleagues formed Clinician Action Network. The group now numbers about 70 physicians, many working in health policy and serving underserved populations, and studies the impact of policy decisions on patients to effectively advocate on their behalf. Obligation to speak out

Ende sees the increased activism as a reflection of a current trend to teach medical students and residents to be sensitive to problems in their workplace. If a hospital system doesn’t provide adequate nursing support or doesn’t address issues about patient experience, doctors have an obligation to speak out and try to push positive change. Speaking out on healthcare policies at the state and federal levels is a natural and logical extension of that trend.

If you are reading this and have not spoken out.  Do so now !  Call or email your congressman or senator. Better yet, visit them in person !

Trump's policies are pressing doctors to speak out | Healthcare Dive