Friday’s Random Thoughts: I’ve long argued that the health care system in America is a mess. (How Did Health Care Get to Be Such a Mess?)

These next words from Kevin Tolliver, a physician with a strong exposure to economics and finance, is a welcome addition to the debate. It’s taken a long time to reach the mess we have and it’s going to take a long time and an attitude adjustment among the citizenry if it’s going to get better.

I was once very hopeful that the ABA (ObamaCare) was going to turn the tide toward a better national outcome. But unless the Democrats take over the House of Representatives in 2 months, we’re going to lose any gains we’ve made. There will be an effort in the lame duck session to abolish it entirely. Be prepared to start shouting from the rooftops.

Kevin Tolliver, MD, MBA/Aug 30, 2018

1. Our health care system is broken, and there isn’t going to be an easy way out. Costs are too high and our outcomes too poor. There’s a lot of finger-pointing in how we got to this point, but one thing is for certain — physicians must lead the way to a better system. The heart of health care is still the doctor-patient relationship and that needs to be protected at all costs. Historically speaking, physicians have tended to shy away from the business side of medicine in lieu of caring for patients, but that’s no longer a realistic option. Physician leadership is a must.

2. Nurses are underpaid and underappreciated. Physicians diagnose and develop treatment plans, but the nurses are the ones who carry things out. They’re present for the good, the bad, the embarrassing and whatever else becomes necessary. They spend substantially more time with patients and families than the physician. A competent, compassionate nurse is an invaluable benefit for a physician and shouldn’t be taken for granted. I feel this more strongly with each passing year I work alongside them.