We all have bad weeks. Mine recently made me marvel at the astonishing dysfunction of our health care system. In calling out the system I intend no disrespect to the talented and heroic overachievers in nursing, pharmacy, medicine and the other providers who fight the system every day on behalf of our patients.
Despite such efforts, the sad but undeniable fact is that our health care system — the way the U.S. distributes and pays for health care — makes it the most expensive failed enterprise in the history of human civilization.
Part of what set me off that week was a series of examples of my patients’ chronic struggles to access mental health services. After years of poor funding and a deluge of demand since the pandemic began, providers are in short supply. Scarcity is coupled with barriers imposed by insurance networks. Absent reasonable access to services, primary care doctors like me become the psychiatrists of first and last resort, pushing the bounds of our competence. But what else can we do?
