I can say that I am nothing short of totally shocked that the Supreme Court largely upheld the Affordable Care Act, known as "Obamacare." With the rightward shift of the Court, I thought it was a foregone conclusion that the health care law was history. Indeed, I have mixed feelings about the law itself: I do feel for the millions of uninsured patients, and if this law can help more of them get covered, that can only be a good thing.
When my late daughter was still alive (and very sick), I was getting shortness of breath (and I'm a lung doctor) looking at the hundreds of thousands of dollars of medical bills that were coming into my mailbox, and that difficulty breathing went away with the knowledge that my insurance was going to cover them. I was so afraid that our insurance company was going to kick off our daughter (something that is illegal under the law), that I would check her status every week or so. Thus, I am sympathetic to the ultimate goal of the law: to decrease the number of uninsured in this country.
At the same time, however, the other provisions of the health care law - and the fundamental overhaul of how healthcare is delivered that comes with it - is causing a tremendous amount of uncertainty for the future, and this causes no small amount of anxiety for medical providers like me. What will the future of healthcare be in this country? What will the system look like? Will the physician-patient relationship be the same? No one knows.
In fact, I am certain that this uncertainty is driving many physicians out of the practice of medicine altogether. In fact, in a recent survey of physicians by Medscape, 54% of physicians said they would choose medicine as a career if they could do it all over again. This number is much less than last year (69%). And I must admit that this uncertainty has worn on me as well.
Then comes a patient like "Kelly."
This patient had a very serious illness that required her to be placed on a ventilator for a very long time. Yet, thank God, she recovered and was able to be taken off the machine, but not before they placed a tube in her neck to help her breathe. After many, many weeks of recovery and rehabilitation, I was able to take that breathing tube out of her neck once and for all. In fact, she didn't even realize that I pulled it out when I told her, with a huge smile on my face, "Congraulations! You're free."
She was in tears, and I almost broke down as well. The happiness I saw in her eyes, the tears of joy I saw stream down her face, the gratitude she felt for something that I really had nothing to do with, they are images that I will never forget. And they remind me of why I became a doctor in the first place: to help people like "Kelly" feel better.
Yes, we physicians face difficulties: a very long time in school, and equally long time in training, an enormous amount of educational debt, and an increasingly less rewarding practice environment. I do not belittle these challenges, and whenever I meet someone who wants to become a doctor, I recount to him or her all the negatives aspects of what it means to become a physician in America today.
In fact, one time, I did this very thing in front of a large audience of pre-med students at a local University. Someone blurted out sarcastically: "Thanks for encouraging us." But that was my exact point: if, after hearing all the ugly things about a career in medicine, you still want to be a doctor, there is no better job in the world.
That's what "Kelly," and the countless patients like her, remind me: that the ability to help people feel better and get relief from illness is a tremendous blessing, one which I should not take for granted. It is an honor to have someone place their total trust in me, and I never take that trust lightly. And if, by the Grace of the Beloved, my patients are healed and feel better, that satisfaction is unlike any other. That opportunity is unlike any other.
So, now that "Obamacare" was declared constitutional and will likely stay the law of the land, many things will change as far as healthcare in America is concerned. And I don't think that my anxiety about the future will ever go away. But, I must always remind myself of that moment with "Kelly" when I took that tube out of her neck, and we shared a moment of tearful joy together.
It will serve to motivate me to keep on going in this field - nay, this calling - that is medicine, because at the end of the day, it is for patients like "Kelly" that I get up (early) each and every day of my life. And I wouldn't have it any other way.