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A Doctor's Vanishing Dream

Joe Cantlupe, for HealthLeaders Media, July 15, 2010

TV and movies have often focused on physicians, truly part of the country's entertainment landscape. There have been certainly enough fictional "doctor" shows over the past five decades, from Dr. Kildare to House, with barely a glimmer of reality attached. As for reality, Michael Moore's 2007 documentary Sicko, touched on physicians, but mostly as a sideshow to his major viewpoint of the U.S. healthcare industry's flaws compared to the rest of the world.

But the underbelly of a doctor's lot: billing codes, malpractice, their feelings about patients, patients' feelings about them, the frustration of only having 10 minutes to give to a patient — haven't been given truly much focus on TV or movies.

At least that's what Ryan Flesher, MD, was thinking. To give his perspective to a doctor's life, Flesher spent four years directing a documentary, "The Vanishing Oath" produced by Nancy Pando, LICWS and released by CrashCartProductions.

Flesher's story is about himself, and also other physicians caught in the whirlwind of the healthcare system, their day-to-day exhaustion and unhappiness woven in a tightening bureaucratic vice. The film was the result of interviews with hundreds of people, not only doctors themselves, but patients, academics, lawyers, and others. It is often sad, but occasionally inspiring.

Flesher, 37, who worked in a Boston hospital emergency department, leaped at the chance to make the film after increasingly becoming unhappy in a system that seemed to unravel, becoming "critically wounded," he said, with doctors bailing out of their chosen profession, because they weren't able to have enough time: for their patients or themselves.

Flesher hated being a physician in a manner that he says the system demands. "It was just pretty frustrating," he says. "Since I was young, I focused on becoming a doctor." Over time, as he grew more unhappy, " I began asking myself, 'what's wrong with me, why am I so unhappy? After four years of filming, it educated me and brought me to a better place. I wasn't alone, there were thousands of people who were also frustrated, their hands were tied by the system, and they were discouraged."

Flesher dubs it the first "physician focused" documentary, and it's good for health leaders to see it from that prism.

On one level, we know the story. Questionable procedures. Too much paperwork. The costs of malpractice suits. Upcoming doctor shortage.

In Flesher and Pando's hands, however, the facts of being a doctor in America today become wrapped not only in numbers, but also in emotion.

It's sad to watch physicians weep with despair over their profession, trying to wring some time for themselves or their families, and frustrated they can't see most patients beyond what their charts tell them, and the few allotted minutes in their schedule. It's exhilarating, however, to watch a few select physicians who say they will never give up on the dream.

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