Sunday, August 2, 2009

Lessons from a Week of Anxiety

It was a complicated story, but I did an interview with CNN last Monday, which, released a firestorm that I would never have predicted. It is more of the fall-out of trying to live down on the first floor (candidly in other words) and makes me wonder if I should keep my mouth shut.

It wasn’t about my Christian perspectives but about my professional work. To make a long story short, CNN has been doing stories about Obama’s health care plan. One issue that came up was the fact that MDs are electing not to go into primary care (family practice) because there they can only earn 165-180 K/year, while they can earn 400 K/year as a specialist. CNN asked the question . . . could PAs or NPs help fill the gap in this coming primary care shortage? I happened to be a PA (Physician Assistant/Physician Associate). As soon as CNN asked the question, several physicians quickly went on their comment page and started saying very cruel (and not based reality) things about PA and NPs (Nurse Practitioners) such as we are dangerous, killing patients left and right, poorly trained, expensive, yada yada yada.

A few of us, both NPs and PAs sent in messages in defense of our professions. Then CNN calls me for an interview.

In the interview, everything I said was true. I made the simple statement that I had not needed to ask my supervising physician a question (and I’ve been with him for six years). But that is not unusual because I’ve been working in headache problems for 28 years. Secondly I made the statement that I could charge a lot less for a patient visit if I did not have to pay my supervising physician’s practice 60% of every dollar brought in.

Next there were a lot of angry letters to CNN by doctors (so I’ve heard as I haven’t gone back to look). Then, the next night a friend sent me an urgent e-mail linking to a web site posting created by some docs for the sole purpose of “Destroying (me) professionally and personally.” The scary thing was that these doctors looked up all my personal information; phone numbers, addresses, fellow employees etc and published them. They were encouraging others to "go after him.” I was perplexed. What had I said that created such rage?

I started to get nervous. Poor sleep and feeling really guilty as the docs vowed to get me fired as soon as possible. I was afraid that someone would try to harm me or someone in my family. It was surreal.

If this story doesn’t make sense to you is the fact that a few doctors are very insecure and to suggest that another profession can do the same job as them (I was talking about an NP or PA with decades of experience, not just out of school, who does not need physician supervision) really scares them. It threatens their earnings (as we make half) and their social status.

I contacted the producer at CNN and he said I could not change my story. I did re-write it, still telling the truth, but in words that hopefully they wouldn’t react so strongly to. The producer said he would remove my interview from the story tomorrow because I’m getting threats.

I have some problems with anxiety and here was an exercise in dealing with it again. Certainly I prayed a lot. I also had to struggle, mentally, with issues of guilt. Okay, maybe some of it was real . . . speaking, stirring up trouble when I should stay quiet. And a lot of false guilt (I did tell the truth).

But I started to think, if this little public expose brought out the kooks, what would happen if my manuscript was published? Would there be some kooky Evangelicals putting hits on me? I expect so.


Don Hendricks said...

This is sad and serious. The politics of personal destruction. I have a situation similar going on because my views of wrath and reconciliation differ from one of my leaders. I would hope for different from your book, but it is worth thinking about.

Hope T. said...

It is frightening to see how threatened people are by the truth. Knee-jerk panic reaction is so common. I agree with Don Hendricks that I would hope that Christians would react differently to your book but I am afraid that you would get a lot of anger directed at you for telling your story. Please remember, though, that just by publishing your story on this blog , you are doing a great service.

pennyyak said...

Wow, I didn't see the interview, but I'm sure sorry about the fallout. When I go for my annual woman's wellness exam, everything is done by nurses and PA's, and there's nothing I do medically where I get more attention, time, good advice, etc. It seems like in some cases PAs have replaced old-fashioned GPs in that way.

My main physician, who is a family practitioner, is similar (although more pressed for time, but excellent in his way), which is why I haven't doctor hopped in many years.

God save us from the power brokers in medicine.

Angela said...

Wow. This sounds like yet another classic example of the Economics of Self Worth. Those doctors must be feeling REALLY threatened and insecure to want to attack you like this. I wish more people could see this for what it really is. Insecurity and fear at work. Maybe then we could actually get to working on some real solutions.

Anonymous said...


Turcano said...

You may find this article by Brad Hicks on the subject, particularly the part about members of your profession being treated as a "servant class" by doctors.

MJ said...

Turcano, Interesting article. This is something that we can't talk about . . .the supply-demand thing. If I said in public (like the CNN piece) that the AMA artificially limits the supply vs demand, would be scandalous. One of the things I said on CNN was that Doctors hide behind the myth that we (PAs) or NPs are dangerous and provide poor care (compared to them). In reality there has only been a couple of studies comparing NPs, PAs and MD care (doctors frown on such studies) and those studies showed the quality of care being the same or better (in the case of HIV-AIDS).

Thanks for sharing that.

Turcano said...

Yeah, the reason I mentioned the "servant class" remark specifically is because it seems to me that a lot of the backlash you got stems from doctors finding your remarks "uppity."