Is the Battle for Medical Care "Real", or Simply Perceived as Real?

In his article "Why Doctors Should Stop Speaking the Language of War" (Forbes, 7/21/2016) Robert Pearl, MD writes that doctors should stop using war-based language to describe the process of providing medical care as this creates an oppositional atmosphere, and the perceived hostility between parties such as physicians and patients prevents cooperation and improvement in the medical system. "Meaningful, positive change can’t happen until people work together.." he writes, "...even when they represent different perspectives".

Pearl was distressed after hearing such phrases as “in the trenches”, and “on the front line” from doctors describing their professional experiences, as these militarized images paint physicians as victims of an unfair and damaging system, rather than as agents of change. He writes: “If our nation is going to address the healthcare needs of 300 million Americans—and at the same time improve the professional lives of doctors—cooperation of the highest order will be essential. Rather than describe ourselves as combatants, patients, physicians and administrators alike will need to forge partnerships for the greater good of all.”

It is true that language creates our perceptions and directs our thoughts. "War" language does create a mentality of "Us vs Them", and Pearl is correct that such perceptions are not conducive to increasing cooperation between different players in the American medical system. Such cooperation is definitely needed, and our nation can benefit from even small steps in that direction.

However, I believe where Pearl errs is in his assumption that the “war” physicians describe is perceived, and not actual. The war in healthcare isn't all in the language. Participants in our medical system regularly report actual and prolonged fighting with insurance companies, with government agencies and other regulators, with pharmaceutical companies and research groups, and (often) between physicians and patients, in the process of creating care. 

From a patient advocate’s perspective, these battles are significant, and very real. The levels of stress patients and families report after years of medical fighting is akin to wartime PTSD precisely because it truly is a serious battle that takes a heavy toll on the unfortunate combatants.

I think Pearl is correct that medical providers need to demilitarize our medical vocabulary, but more importantly, we need to demilitarize our medical system. As long as the process of creating care takes place in trenchant and stressful battles between patients and providers, providers and regulators, regulators and industry, and others, medical care will continue to feel warlike and polarized, because it truly is warlike and polarized.

What do you think?

Link to the original story:  http://www.forbes.com/sites/robertpearl/2016/07/21/why-doctors-should-stop-speaking-the-language-of-war/3/#6a9f91157d20