Physicians Aren’t Immune to Feeling Entitled

During the national debate over our ballooning debt, there has been a fair amount of talk about entitlements. In that context, “entitlements” refers to social programs such as Medicaid, Social Security, disability, and the like - programs intended to help members of society who are less fortunate and more in need. It is not uncommon to hear a disparaging tone from those speaking of entitlements, particularly when the speakers are paying into the system but not receiving benefits from the programs.

In healthcare, we see some of the inefficiencies of these entitlements more closely than others in the population. Primary-care specialists have endless stories to tell of patients who arrive in Medicaid cabs, owing nothing for their treatment, yet somehow have the means to sport the latest trendy sneakers, designer labels, top-model cell phones, and enough gold jewelry to do a rap-star proud. Or the perfectly-healthy patients who want disability forms signed so they can continue to receive checks in exchange for not working. Certainly, not all recipients of entitlements are abusers of the system - but there are enough out there that you may have heard the sarcastic diagnosis of “Entitlementiasis,” the condition of sucking as much out of the system as one can, and fighting tooth and nail for the continued right to do so.

It’s often overlooked that entitlementiasis can occur in other segments of society, even those that are quite well off. Consider a multimillionaire paying little or no tax because of loopholes in the law, and what his reaction might be to a proposal that would close those loopholes. He could very well be enraged by the idea, although he might have a hard time explaining why he should be entitled to the loopholes.

How about a hospital’s CEO who has a plum parking-spot, while all of the physicians who make the place function are relegated to the distant corners of the lot? You can bet the CEO would vigorously defend his entitlement to his spot, if it were suggested that he had no more right to it than anyone else.

Physicians are not immune to entitlementiasis. Consider a senior member of your team who does half the work of everyone else but throws a fit if it’s suggested that some of his ample wages should be going to the harder workers.

Or the colleague who decides that he doesn’t feel like taking call anymore, but isn’t willing to give up anything to compensate those he expects to cover his shifts.

How about a new hire who doesn’t want to re-qualify for MQSA in order to read his share of the mammo workload?

It only takes a little discipline to prevent yourself from contracting entitlementiasis: Be willing to challenge yourself by asking why you feel you deserve something, and how your pursuit (or defense) of it is coming across to those around you.

It’s much harder - often impossible - to cure others of their entitlementiasis, especially if they don’t see it as a problem. Getting them to relinquish entitlements to which they have grown accustomed is a severely uphill battle; it costs far less time and effort to prevent them from acquiring such extra privileges in the first place.

Don’t expect the newly-unentitled to react gracefully, either; even if they win the battle and find a way to keep their entitlements, they’ll remember who tried to take their goodies away, and such grudges are not quickly forgotten. Maybe that’s why entitlementiasis is so rampant - it’s easier to just keep your head down and learn to live with an uneven playing-field.