A Psycho-Anatomy for the Practice of the Unknown Greedy Doctor – Pay Gold for Gold

Greed is a natural human impulse. Like many other human impulses, this one requires us to keep its wildness under control; otherwise, its consequences will harm everyone around us.

I am a greedy doctor, I like money and enjoy it; what’s even better is that while I make money, I feel a sense of fulfillment that I’m making money while serving a purpose in life, that feeling when a patient tells me “I prayed and thanked god for you doctor” a feeling that gets me going and it’s a bonus if I get it more than once a day, only the love of my 4 daughters tops that.

How can we reach that destination? Learn science, medicine, and clinical bedside practice and repeat those activities hundreds of times to improve. For me, a 6”4 tall, large Middle Eastern man approaching an anxious vulnerable patient, I have learned to smile more, speak slowly and softly, listen more, and let go of the white coat, so I present as a smaller mountain. The rewards start when you gain patients’ trust and help improve their quality of life.

The subsequent emotion arises when I exhaust all available options to assist a patient, but I cannot provide help, making the earned money less deserved. However, I still accept it because of my greed.

Then comes the sense of responsibility for causing harm to a patient by neglecting something or not giving enough reflection or time. That money leaves a distasteful sensation even for my greed.

At the deepest depths of my emotional well, the most insufferable sensation I have ever encountered, to observe patients being negatively and systematically harmed by my peers and the system profoundly affects me and churns my insides; it’s visceral 🤮.

Amid all the suffering in the system, exceptional doctors persevere. They battle their demons of greed and selfishness, putting their heads down and marching on every day. With incredible empathy, judgment, and experience, they provide exceptional patient care, helping them achieve a better quality of life.

Like other humans, doctors are a spectrum, multidimensional like my spider chart below, where you see the taming of greed, great skill, and judgment applied to the benefit of their patients.

DrA. and all peers in the center, then Dr.Z with his untamed greed, and ego, and the results are disastrous to patients and lucrative to DrZ and his sponsors.

Our Modus rating system showed the above neurosurgeon did 100% surgeries on everyone who walked through his door and much worse. He was a “workhorse, superstar” to the hospital admistrators “In October 2019, MultiCare placed Dreyer on an incentive compensation structure because he had been performing a high volume of surgeries and generating significant revenue

Today, doctors make the big bucks when there is an industry sponsoring them,

Device manufacturers: Such blatant abuse of patient trust has been frequently documented by members of the Association for Medical Ethics

Pharma: More drugs more money

Hospitals: more surgeries, admissions, tests etc.

DrAs have no industry to sponsor them, and the crazy irony is that DrAs don’t realize that they are exceptional; they are unknown in the massive system. To the system, all doctors are commodities paid the same fees for units billed. The system’s only measure of value is; lower fees per unit. So, when the system discounts fees per unit, it penalizes DrAs because they earn less for the same work while rewarding DrZs who increase their units to earn more money, ultimately causing patients to suffer.

In today’s system, all doctors are treated as commodities and receive the same fees per unit regardless of whether they are timber doctors or gold doctors. The golden DrAs are being undervalued compared to the timber DrZs, but their work quality is widely different.

I periodically receive letters from local health plans in my practice telling me: “Our consultant audits show a pattern of you billing 50% more level 4 visits than your colleague in the same area and specialty, we are watching you”

My response is “choice word”, how about you measure how many of my patients end up being operated on, injected, admitted to hospitals, using Opioids, and compare me to my colleague that way?

These same health plans kept Farid Fata, MD on their network until he was arrested by the FBI for fraudulently diagnosing noncancer patients with cancer and treating them with chemotherapy. These health plans abdicate their duty by waiting for the DOJ to improve the quality of their networks’ doctors.

We can do better, it’s simple, but simple is hard:

  • Find the gold in the unknown doctors
  • Support them with tech so they keep providing the golden standards of care
  • Quality of Care = Quality of life: Measure patients’ quality of life: are you better or worse off after being treated by a specific doctor
  • Investment:
    • Monthly fees to guarantee access
    • Fees for service encounters to discourage apathy
    • A bonus for higher patients’ quality of life and lower costs.

We need investments in these doctors so their conservative, thoughtful care can survive and thrive, and more doctors will behave like DrAs.

They combine science, compassion, and impulse control and give their patients a great quality of life; they THINK TWICE AND CUT ONCE.

There is nothing wrong with making money, lots of money, as long as we give value for it.

It’s time to pay gold for gold.

Ali Alhimiri, MD
Founder and CEO

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