I was reviewing a number of articles and came across one discussing “Nearing End of Life Effective and Compassionate Communication Strategies.” Reading this article generated questions regarding the possible future of our degradation of the emotional connection with our patients as well as the relative absence of effective communication with our patients.

When the Affordable Care Act covers 31 million more patients giving them accessibility to a delivery system that is already stressed with inadequate physician per patient ratios. Therefore, the physicians will be forced to see an increased volume of patients decreasing the time spent with each patient, especially in primary care practices. However, the President is attempting to set aside funding to educate primary care physicians. However, the funding is only for certain demographic areas of “need.”

I really believe that when we reduce communication and the emotional, compassionate connection with our patients we also lose the trust of our patients or as we transition into the new world of Health Care they only become customers or clients.

As a physician that has been practicing for just about 30 years I am deeply troubled by the change. Teaching a course in the Public Health School at Hopkins gave me a whole new outlook regarding the ethically good. I agreed with the class that we need to provide health care for “everyone.” But this is not guaranteed by any official written document. It is ethically correct but we need to get the whole equation worked out. Those that wrote this law still haven’t worked out the details. We need to address the cost of medical education and tort reform. Otherwise physician behavior, therefore the cost of delivering health care will continue to rise.

How do we make it sustainable?

Or do we assign the tasks of caring for our patients to nurses, nurse practitioners and physician assistants?

Suggestions, comments and or solutions?