Wednesday, December 28, 2016

Pouring from an Empty Glass

It is widely believed that the American healthcare system is broken, judging by the ratio of costs to outcomes in comparison with other nations. Perhaps one measure of this brokenness is the degree of burnout among those who work in the system. Though the work can still be rewarding, and one cannot yet assign a direction in causality, there is evidence that psychologists, physicians, and others are often emotionally depleted in their work, and that this state is related to reduced or poorer outcomes for those they serve. Some authors believe that industrialization of healthcare and the influence of the pharma-insurance conglomerate has and will continue to produce an environment driven by profits and not by any measure the healing relationship.

I was once the 76th patient to sign in to see a physician. I wondered how in the world he could muster the focus and energy it would take to see me. A sad state of affairs indeed. Many who practice the healing arts and science may be pouring from an empty cup.

There is nothing inherently wrong with the profit motive. But time with another human being is also an important motive, and these two motives must be in at least an effective balance for healthcare, and specifically psychotherapy, to work well for consumers. It is for these reasons that psychotherapy does not belong in medical environments as they are currently structured in broken healthcare systems. In such settings therapy is a square peg in a round hole, and it morphs into 15-minute consultation visits after the most cursory of screenings. I once learned of such an office which employed a three-item depression instrument. Friends, it is not possible to know someone with only three allotted questions.

There must be an effort to constrain the trend to subjugate time to profit in healthcare systems. This and other forms of contamination in healing are not resulting in better care. It is, I believe, wearing out the healers. It is also distorting the psychotherapy process which is inherently time intensive but the data have repeatedly shown it is well worth the investment. We need to fill the glass so that we can pour for others.