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Policy Over People

December 17, 2019
Photo: Pexels

“On reaching Jerusalem, Jesus entered the temple area and began driving out those who were buying and selling there. He overturned the tables of the money changers and the benches of those selling doves” (Mark 11:15, NIV 1984).

 

They called me from the church today. One of the homeless women staying there had developed a painful rash. I drove over, documented an acute H. Zoster infection and wrote the prescription for acyclovir, prednisone and a few hydrocodone. Later today I had fallen asleep on the floor at home and awakened to spot a text from my friend who was helping the homeless that weekend. I had forgotten to date the prescriptions and the pharmacist refused to fill them or call me. The woman had returned to the church, so I drove over and corrected the prescriptions, angry the whole time that the pharmacy had sent her away suffering rather than calling me to fix things. “Our policy won’t let us call the doctor,” the pharmacy tech had told them.

 

I realized I was angry more at the process than at the tech who was following orders. Policy over people.

 

Unfortunately, our entire healthcare system is shifting toward policy over people. Whatever the causes, healthcare has shifted to a business model rather than a people model: doctors’ answering machines you can’t speak to, pharmacy techs who won’t call doctors, insurance denials interpreted by those with no healthcare training, guideline-driven patient care, rigid scheduling, productivity scorecards—all with the stated goal of improved patient care, driving us farther and farther away from personalized medicine. Policy over people.

 

There are some things that we as Christian professionals should fight for. One of them is people over policy.

 

Obviously, policy is good and important and necessary. It demands our input and commitment. We, as Christian healthcare professionals, and as Christians in all walks of life, should follow good policy, but we should always keep our hearts open to the person before us. We should examine the policies in our practices and deliberately discover areas where changes need to be made to put patients first, and situations where individual patients fit outside the good intent of the policy.

 

When the person before us needs a tweak in policy to make them whole, we should take the personal risk and make the tweak; and when policy causes harm, there are times when we should shatter the policy, as Jesus did when He overturned the tables.

 

Dear God,

Let me never let go of my covenant with my patients and thereby treat them as customers of my practice.

Amen

Al Weir, MD

About Al Weir, MD

After leaving academic medicine, Dr. Weir served in private practice at the West Clinic in Memphis, Tennessee from 1991-2005 before joining the CMDA staff as Vice President of Campus & Community Ministries where he served for three years from 2005-2008. He is presently Professor of Medicine at the University of Tennessee Health Science Center and Program Director for the Hematology/Oncology fellowship program. He is also President of Albanian Health Fund, an educational ministry to Albania where he has been serving for 20 years. He is the author of two books: When Your Doctor Has Bad News and Practice by the Book. Dr. Weir’s work has also been published in many medical journals and other publications. Al and his wife Becky live in Memphis, Tennessee, and they have three children and three grandchildren. Dr. Weir is currently serving on CMDA's Board of Trustees.

1 Comment

  1. Avatar Eric Gokcen, MD on January 28, 2020 at 4:21 pm

    Hi, Al,
    Right after reading this, I was stuck on the phone with a pharmacy tech for 30 minutes, trying to figure out a discharged patient’s medications. It became quite frustrating, but then your words “policy over people” came to mind and came to life. Thanks for reminding us to keep focused on our patients and not the system (or those also stuck in the system, like pharmacy techs).
    What you’ve written is quite good and I believe would have universal appeal to all physicians. Would you consider having it edited a bit for the general physician population and submitting it to a journal like JAMA? I would be more than happy to do that if you’re interested.
    Thanks,
    Eric Gokcen, MD
    Associate Professor of Orthopaedic Surgery
    Temple University
    Philadelphia, PA

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