I spent this past weekend at a wonderful wedding in Richmond, where I lived for over 20 years. At the reception I had an important conversation with one of my former residents (I was an intern and he was a 2nd year). I knew him before medical school, and have kept in touch for the past 37 years during which he worked in a classical internal medicine practice.

He quit primary care this year.

He loved his patients, and his patients loved him. He has a wonderful bedside manner, and is thoughtful and refuses to rush through his patients. He cannot do it anymore.

If this story was unique, then I would not write this rant. But this story is becoming commonplace.

Physicians want to care for patients. We want to spend sufficient time with the patient so that we can fully understand the patient’s problems. We try our best to aid our patients in the many dimensions of their illnesses.

We despise seemingly stupid documentation rules, which lead to many clicks in the EMR. We hate pre-authorization requirements and device forms. We burnout when we are told that we are spending too much time with each patient. We burnout when the “suits” have no respect for our working conditions.

This physician has a job with the hospital now. His patients have to find another physician, not because he was tired of caring for them, but rather because the administrative complexities of modern practice put a dagger in his spirit. These complexities, all developed to standardize care for the better, are hurting patients. When we drive physicians like my friend out of primary care, we have a broken system.

As we discussed his personal situation, I could only nod and empathize. Unfortunately, this is not a new story, rather it is an increasingly common one. I am tired of hearing it. But do the perpetrators of this nonsense understand in any meaningful way?