As a physician anesthesiologist, I am well-trained in managing airways and placing breathing tubes in patients. Therefore it is no surprise that my colleagues and I were summoned as the first line of providers to intubate Covid patients who require a ventilator. This is one of the most dangerous procedures a physician can do for a Covid patient.
During my career, medicine has changed dramatically. In the beginning, I owned my own practice and had the autonomy to make intelligent decisions for my patients. Now, most of my previous practices have been sold, either voluntarily or by force, to large corporations funded by private equity. My experience with these large companies is that profits are more important than the health and safety of our patients.
When Covid arrived in March of 2020, things went from bad to worse. One hospital where I formerly worked irresponsibly continued to do elective cases despite urgings from the U.S. Surgeon General to stop. An expose´ was published by NPR showing that elective cases continued despite the fact that the hospital was running out of PPE and the ICUs were filled to capacity with Covid and other critically ill patients.
Providing care for Covid patients does not reimburse well and many physicians, myself included, were warned that salaries would be cut drastically. The financial burden of Covid did not land on corporate investors, but landed squarely on physicians and taxpayers who bailed out many of these companies.
Despite the drop in salary, long shifts, and late nights I was willing to work and give back to my community. However, I was told that our hospital didn’t have enough PPE. The message from administrators to our community was that they had ample supply and there was no need to panic. But behind closed doors, healthcare workers were told to reuse masks indefinitely unless they were visibly torn or soiled. I asked neighbors and friends for PPE donations, and they generously stepped up with N95 masks, face shields, and respirators. But when I tried to wear the N95 or respirator in my hospital, I was told that it was against hospital policy and that I was scaring patients.
It would be nice if physicians could turn to the government to protect us during the Covid epidemic, but that hasn’t occurred. The arrival of a vaccine is a welcome turn of events, but there isn’t yet enough to go around. Not all health care providers are being offered the vaccine and some hospitals aren’t getting any at all. However, the Senate Majority Leader, Speaker of the House and President Elect, appear to have full unencumbered access to the vaccine.
I have two young daughters at home and I have realized that I can stay healthy and raise them, or continue to work under these conditions and put my own life at risk. Talking to my colleagues, I am not the only one leaving or contemplating an urgent departure from medicine. I recently submitted a recommendation for one of my very experienced colleagues who is leaving medicine to go to law school. I foresee a massive shortage of physician specialists right when our country and healthcare system will need them most. The corporatization of medical practices, the mismanagement of hospitals, and Covid created a perfect storm for many of us to decide it is time to hang up our stethoscopes.
Cases will surge in the coming weeks mainly due to people who ignored the suggestion to stay home and isolate for the holidays. The good news is we now have enough ventilators for patients. The problem is we may not have enough physicians willing to run them.
Dr. Justin Meschler is an anesthesiologist with over 15 years of experience. He has a PhD in pharmacology and physiology and has authored and published multiple scientific articles. He served as the OR medical director at a Level One Trauma Center in Central Georgia before moving to Colorado. He is now retired from medicine at the age of 48.
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