I SAY, I SAY: Change is inevitable

My friend Bill – not his real name – says what is happening to him in his personal life is similar to what is happening in the health-care system. Now he regrets he did not anticipate or prepare for these changes.

Changes in life are inevitable. Sometimes they are good, sometimes not so good. Sometimes they come suddenly, sometimes slowly. But things change all the time. What counts is how we anticipate, plan for and handle change.

Let us look at Bill’s true-life story.

Three years ago, Bill celebrated his 50th birthday. He was married with two children, a boy, nine, and a girl, seven. Bill was at the peak of his practice as a surgical specialist. He had plans to retire at 55. In fact, his financial advisor had made plans for Bill’s retirement in year 2002.

Bill’s main consideration was his children. They were very young and he wanted to put some money away for their education. He felt confident that with another five years of hard work he would be home free.

Well, people or nature can sabotage even the best-laid plans. That is what happened to Bill. A few months after his 50th birthday, he developed health problems. This put a significant scare in his head and he realized nobody is guaranteed immortality in this world – young or old.

Bill had to make significant changes in his practice, resulting in a major financial loss. His disability insurance did not kick in, as he was physically thought to be well enough to work. Mentally, he felt very insecure. He wanted to reduce the risk factors in his life to prevent deterioration in his health. Cutting down on stressful work was one way to do it.

Three years have gone by. Mentally and physically Bill has not done badly. He has curtailed his expenses (cutbacks) and managed to survive with limited income. But his children are now 12 and 10. Their needs and expectations keep mounting according to market popularity (peer pressure).

This is what is happening in the health-care system. The governments and health authorities may survive or limp along with cutbacks and limited resources, but people’s needs and expectations do not diminish. In fact they increase as new ways of diagnosis and treatment enter the market.

As we know, this is where governments have failed. They have no political will to change people’s expectations in a changing environment of “fiscal responsibility.” The burden falls on the physicians who are “independent practitioners” but still have the responsibility to do governments’ dirty job of rationing health care.

How can we be “independent practitioners” when we are controlled by two masters – the governments who pay the piper and patients who call the tune?

Physicians are angry and totally demoralized, as we did not anticipate the speed or prepare for the changes in the health-care system. These changes have been coming fast. And there is promise of more to come. But we – and our leaders – continue to fight change instead of becoming part of it.

Like stress, change is part of our lives. It is not going to go away. The question is: How do we plan to handle it?

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