The United States has the largest health-care workforce in the world, with an estimated 6 million doctors, nurses and other health professionals in the country at any given time.
But the quality of their work is declining, according to a new survey by the organization Physicians for a National Health Program, along with a five-state research consortium led by Johns Hopkins University. Some say their professional immunity from managerial interference and corruption has been eroded.
The study’s authors want to challenge an official National Health Service in the United Kingdom that the England and Wales Medical Association recently labeled as “a dictatorship under pressure from Health Secretary Jeremy Hunt.” Last week the NHS lost 250 medical staff, mostly nurses, as part of a “resignation tsunami” fueled by staffing shortages.
Dr. Benjamin Sommers, the study’s senior author and a public health researcher at the Johns Hopkins Bloomberg School of Public Health, said the situation may be of concern for U.S. leadership too.
“If there’s anyone in the U.S. government who needs to hear about the NHS, it’s officials in the White House and Congress,” he said. “We’re seeing that America is fighting for its survival.”
In the survey, Physicians for a National Health Program identified 19 communities with significant health-care issues in which, over a five-year period, the responses to questions about patient care dipped. The responses are not statistically significant, but they paint a harsh portrait.
“I get no respect from the people at work, from patients, or even my boss,” one physician said. Another described the climate as “very toxic, ” and one described the “stress and dysfunction that has built up over time with severe distortions in our institutionalization and values.”
The symptoms include shorted shifts, drug and alcohol abuse, poor communication, unhealthy work conditions and a lack of timely and effective care for patients.
In an accompanying editorial in the New England Journal of Medicine, Steven Tatnall, a health-policy professor at Northwestern University, noted the concerns captured in the survey, even as he said that “it should be noted that the survey, taken before the recent resignations, did not see strong signs of any serious decline in quality or access to care.”
But the immediate trends are troubling, Sommers said. Public concern about long waiting times and shoddy treatment, even in a country of more than 50 million people, suggests a tipping point, he said.
At a recent event on the study, hosted by Policy Watch in Ann Arbor, Michigan, University of Michigan professor Lisa Porter called it “a leadership and governance crisis.” She urged the medical profession to support new patients who need appointments from doctors and doctors’ aides: “Whatever your beliefs, look at the data.”
Anna Netrebko, who was at the event to hear from and take part in policy initiatives designed to ease patient-doctor communication and reduce delivery practices, added that “the public feels that the medical profession has failed them.”