They Codified Everything Except the Part That Makes Us Physicians
They codified everything except the part that makes us physicians.
There is a CPT code for visit complexity. There is a code for time. There is no code for the moment a patient grabs your hand and says they are scared. No code for walking a family through a diagnosis that changes everything. No code for the clinical instinct that catches what the algorithm missed, because algorithms cannot interpret tone, do not see body language, and are not human.
Since they cannot understand it and quantify it, they choose instead to ignore it. They decided it was worthless. That it must be meaningless. They remind us this every day because they do not provide a code for it.
They are wrong. We still account for it.
Every physician takes account of this on every shift, in every room, with every family standing in a hallway waiting for someone to tell them what happens next. We carry it home. We carry it into the next shift. We carry it for decades until we cannot anymore.
The System did not erase the work. It just stopped acknowledging it by stopping payments for it. Now, the System acts surprised that all these extremely skilled, talented, and educated people who have been doing this extremely emotional, depleting, and critically important work are leaving the system.
System, hear me now: Our judgment is not a line item. Our training is not a cost center. Our name is not PROVIDER. We are PHYSICIANS.
The uncoded parts of our profession that this bureaucratic nightmare CHOOSE not to account for are the parts that keep people alive. It is what ensures people use healthcare appropriately because they trust their doctor because “my doctor listens to me” and that was how our advice to patients was acted on by them.
But decades of shrinking appointment times, double and triple booking, doing everything possible to extend our reach without ever asking us if we were ready to do more. Making us less effective by taking away our ability to listen and advise.
Physicians are seeing more patients with less time. This is stretching our emotional empathy capacity to the thinnest of limits. For some, too thin.
They refuse to account for what only we can do. So, we continue to leave. In our doing so we recognize that this is disruptive and it may adversely affect some of our patients. But the System will never change if we do not go. Until the System accounts for what it has refused to codify, the System remains unchanged.
Physicians did not make the decision to keep an unjust system. We have decided to no longer be complicit with injustice. The shortage is the choice the System made.