My name is John Dorsky, MD and I am a Board Certified General Surgeon. I have been practicing for over 30 years. As a physician, I tried to deliver high quality, compassionate care. I believe that was a key to my success.
It is no secret that medicine has changed dramatically since I finished my training. I have certainly witnessed it first hand. The nature of care delivery has moved away from "your doctor who knew all about you" to large institutions with a team of caregivers that are a metaphor for the current "maze" in the health care system. In fact, changes in how doctors are trained have had the unintended consequence of impacting the concept of "physician ownership" which has been observed by myself and others involved in teaching the next generation of doctors. Care, now, is often by a committee of people. Some often seem very pressed for time, and have limited availability to sit and review any given patient's problems with that patient or their family. Private practice physicians have become non-existent in many areas, and "Big Box Medicine" where large hospital systems employ numerous physicians has become the current model of care delivery. This model, and associated economic forces has encouraged the proliferation of "physician extenders" ( physician assistants [PAs], clinical nurse practitioners [CNPs], and Advanced Practice Nurses [APRNs] ) who are the primary interface for patients, and often surrogates for delivering care. I have worked with many physician extenders. Some of them are excellent, but there are many who have had far too little clinical exposure to be good diagnosticians. Having them be the front line of the patient-physician interaction can be problematic. Perhaps you have experienced less than ideal interactions in moments of greatest need, when you are sick. This problem will only become more prevalent in the future. There is already a shortage of doctors in this country, and it takes 10-15 years to train a new one. This is an impending/ongoing storm that many people don't fully appreciate until they are in the midst of difficult medical problems and frustrated by the resources available. I have frequently been contacted by my own friends and family to help when they have difficulty navigating the "medical maze". Sometimes, the difference between survival of a critical illness and an un expected death can be the attention to detail that, unfortunately, can be missing from the clinical world today.
For these reasons, I have elected to create a place to turn to when care delivery does not meet expectations. A place where you can get answers when you are not satisfied with what you have been told. A place where you know there is not financial incentive to do a procedure or test, if it is not really needed. A place to ask for guidance before there is a "bad outcome". A place where there is no incentive to "bury the truth" because someone missed recognizing a problem before it was catastrophic. A place to get piece of mind that you made the right choice. Not everyone will need to be here. If you do, I hope and believe that you will be happy to engage this service.
Everybody has the right to expect that they will be offered the best care available.
John Dorsky MD FACS CWSP WCC CPHIMS