Business Insight presented by Arlington Dermatology Reality and Fiction Some of you who read my columns regularly know that I often refer to real life books, shows, or other events. I always seek my own reality in them or at least reference to them. My recent watching is 'Resident' series presented by Netflix. While it is a product of fiction, with all human interactions, it is also a reflection of reality in the healthcare system. I have been paying a lot of attention to the healthcare world changing around me. The fact that I see a lot of patients coming from as far as Rockford because many of the doctors in that area are not practicing independently and are a part of large administrative and financial groups run by private equity, seeking profits only and not accepting many of the insurance plans. I see a lot of my peers from residency facing decisions to sell their practices because their areas are overtaken by the same administrative and financial mega- groups. I also hear about patients whose clinics and hospitals were closed because they did not bring enough profit. On the other hand, I see a tremendous administrative burden in the same clinics and hospitals, with shortages in nursing staff and over hiring of clerical personnel, with low or no prior healthcare experience and hardly any skills. It is not uncommon for the large groups to hire mid-level providers, Physician Assistants or Nursing Practitioners, and provide little or no training, and just throwing them into clinical operations, seeing patients. There is no concept of 'too much training' in healthcare, especially in specialty healthcare. Graduates from PA and NP schools are excellent material for good providers, but they must train, for months, in the shadow of doctors, learning practical skills and diagnostics. You cannot learn to be a doctor from a book. You acquire skills by practicing. And your initial steps in practicing must not be experimental, they must be under supervision. Certainly, when in training, these professionals do not bring money. Thus, when money is the primary goal in healthcare, the concept of extended training does not work. This is why potentially great, mid-level providers make mistakes and errors in diagnostics and patients ultimately suffer. I am not a dreamer, I know businesses, including healthcare, must bring in money to exist. But money cannot be a primary focus. As medical doctors, we deal with suffering of patients, life and death decisions, long-term illnesses and more. Some of us, working in the hospitals only, get easily burned out by the number of patients and complexity of medical decisions. We also must learn how to maintain compliance with massive regulations and standards of care, which sometimes is not easy. As long as our focus is on patients, we are successful in fulfilling our medical oath. I feel really bad about patients travelling to see me for 60-90 minutes, because their insurance. And I know that in some there is no dermatologist who accepts rural areas, it is even worse. We are the richest country on earth. We lead in medical technology. We have excellent medical schools. We should not be allowing patients to suffer or lose their homes just because they got sick or had a bad accident. If you find some time, watch 'Resident' and think not about love stories but about healthcare reality it intelligently shows. Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net Business Insight presented by Arlington Dermatology Reality and Fiction Some of you who read my columns regularly know that I often refer to real life books , shows , or other events . I always seek my own reality in them or at least reference to them . My recent watching is ' Resident ' series presented by Netflix . While it is a product of fiction , with all human interactions , it is also a reflection of reality in the healthcare system . I have been paying a lot of attention to the healthcare world changing around me . The fact that I see a lot of patients coming from as far as Rockford because many of the doctors in that area are not practicing independently and are a part of large administrative and financial groups run by private equity , seeking profits only and not accepting many of the insurance plans . I see a lot of my peers from residency facing decisions to sell their practices because their areas are overtaken by the same administrative and financial mega- groups . I also hear about patients whose clinics and hospitals were closed because they did not bring enough profit . On the other hand , I see a tremendous administrative burden in the same clinics and hospitals , with shortages in nursing staff and over hiring of clerical personnel , with low or no prior healthcare experience and hardly any skills . It is not uncommon for the large groups to hire mid - level providers , Physician Assistants or Nursing Practitioners , and provide little or no training , and just throwing them into clinical operations , seeing patients . There is no concept of ' too much training ' in healthcare , especially in specialty healthcare . Graduates from PA and NP schools are excellent material for good providers , but they must train , for months , in the shadow of doctors , learning practical skills and diagnostics . You cannot learn to be a doctor from a book . You acquire skills by practicing . And your initial steps in practicing must not be experimental , they must be under supervision . Certainly , when in training , these professionals do not bring money . Thus , when money is the primary goal in healthcare , the concept of extended training does not work . This is why potentially great , mid - level providers make mistakes and errors in diagnostics and patients ultimately suffer . I am not a dreamer , I know businesses , including healthcare , must bring in money to exist . But money cannot be a primary focus . As medical doctors , we deal with suffering of patients , life and death decisions , long - term illnesses and more . Some of us , working in the hospitals only , get easily burned out by the number of patients and complexity of medical decisions . We also must learn how to maintain compliance with massive regulations and standards of care , which sometimes is not easy . As long as our focus is on patients , we are successful in fulfilling our medical oath . I feel really bad about patients travelling to see me for 60-90 minutes , because their insurance . And I know that in some there is no dermatologist who accepts rural areas , it is even worse . We are the richest country on earth . We lead in medical technology . We have excellent medical schools . We should not be allowing patients to suffer or lose their homes just because they got sick or had a bad accident . If you find some time , watch ' Resident ' and think not about love stories but about healthcare reality it intelligently shows . Michael Bukhalo , MD Arlington Dermatology 5301 Keystone Court Rolling Meadows , IL 60008 Tel . 847 392 5440 | www.arlingtondermatology.net