1. “I’ve been a registered nurse for 32 years. When a patient starts to go ‘downhill’ during surgery, they are quickly closed up and transported to the ICU to die there. This assures that the surgeon and hospital do not have a statistic of death from surgery.”
—Anonymous, California
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2. “I became a paramedic makeup artist in the ’80s while I lived in Orlando. There are so many instances, but the one that stands out the most is when I first got into the field, and I was calling on mostly plastic surgeons and dermatologists about my role in inpatient care. The doctor who stood out to me was the one who wanted to tell me how much money he made as a plastic surgeon. I don’t care how much money you made. All I care about is what kind of surgeon you are. He was a lousy surgeon. The egotistical, narcissistic people that I encountered during that time could fill a book.”
—Anonymous, 77, Alabama.
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3. “I was a physical therapy tech. My job was to assist patients with exercises. I cannot tell you how many times I was the only person that they saw. Of course, their insurance was billed as if they had seen the PT assistant in person. Yes, including Medicare and Medicaid. Fraud!”
—Anonymous
4. “I’ve been appalled at the disgusting hygiene of some doctors and nurses. Picking up gloves from the floor and thinking nothing is wrong with using those now-dirty gloves.”
—Anonymous
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5. “I’m an RN. By law, you cannot perform a procedure that you have not been trained in and signed off on. While working in the ER, I was ordered to do a lavage (purge the stomach of toxins using a tube and fluids) of a drug overdose patient. It’s not a common procedure, and I had neither been trained to do it nor signed off to do it. When I notified the charge nurse and ER doctor about this issue, neither cared and ordered me to do it or be fired on the spot. I asked if at least another nurse who had done a lavage before could assist and instruct me, and was told no, because we were short-staffed.”
“I reviewed a video of the procedure on my cellphone quickly and proceeded to complete it, terrified I was going to harm my patient. Fortunately, it all went well, but afterward I submitted my resignation with two weeks’ notice and switched to working in hospice. I never went back to working in a hospital ER or ICU again. I warn people never to use that hospital for their care, that it isn’t safe to go there. Profit always seems to win over safe patient care.”
—Anonymous, 72, Florida
6. “I’m a physician. Everything you hate about healthcare is because it saves CEOs and insurance money, or makes them more. Inadequate nurse staffing? Saves money, has worse outcomes, particularly for minority patients (women and people of color). ED boarding? Saves nurse staffing, incentivizes patients to leave, and decreases bed availability, which saves money. Pharmaceutical prices? Yeah, that goes to the insurance and pharmaceutical companies. Ozempic is around $200 in Canada and can cost over $1,000 in the US. Less time with the doctors? Time is money: Seeing more patients makes more money… It goes on and on.”
—Anonymous
7. “I’m a physician. If you tell patients the truth that their insurance is denying meds because of cost or something, sometimes the insurance company will send someone to your clinic and threaten to take you out of network so you can’t see their patients anymore. They literally threaten doctors to lie.”
—Anonymous
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8. “Surgical assistant here. I’ve seen anesthesiologists take pictures of patients under anesthesia and show them around. I’ve had to tell surgeons they have marked the wrong eye or cut an eye muscle and tell them how to repair it. I’ve seen doctors detach retinas with needles and still get thanked for taking care of their eye.”
—Anonymous, 72, USA
9. “My sister is a nurse, and she’s told me that there are lots and lots of mistakes. They had a nursing student give someone a drink before he went into surgery (which he was supposed to have on an empty stomach). Also, a nursing student accidentally killed a patient on the sister’s ward (she wasn’t the head nurse). Gave the guy too many painkillers or something like that and killed him by accident.”
—u/[deleted]
10. “The fact that you have to ignore the cries of ‘help me, help me’ or ‘nurse, nurse, nurse’ when doing ward work.”
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11. “[The lack of professionalism.] I worked retail during my teen years and thought, ‘Once I start working in a hospital with medical professionals, there’s no way they would act like X.’ Lo and behold, sadly, it’s not much different from my past retail job. I’m just much, much busier.”
12. “I worked as a case manager at a for-profit long-term acute hospital many moons ago. I left because I thought it was very unethical, even though I made bank as a social worker. Back then (2013-ish), the discharge date was determined by DRG (diagnosis-related group) payments and was totally divorced from what was in the patient’s best interest. I got a printout every morning of when people needed to be discharged by for maximum profit, and on what date we would start losing money. People were often hastily discharged to a lower level of care, ready or not, when their DRG date came up.”
“Then, we got into a length of stay crisis because we were discharging too quickly (the rules at the time said an LTACH [long-term acute care hospital] had to have an average length of stay of 25 days). When this crisis was identified, people were kept longer than necessary. It was awful. I had a CEO breathing down my neck constantly. I sure hope they have reformed things since then.”
13. “MD here. There’s so little we can do for patients who have serious mental illness or are chronically encephalopathic. They run into a vicious cycle of getting hospitalized and then being unable to be discharged because they can’t take care of themselves, and no place will accept them because of their behavior; also, they are mentally incompetent and can’t be released by choice. They don’t get better. There’s a point of no return in mental illness.”
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14. “MD. Hospitals are very hesitant to discipline surgeons who have bad skills, even though they are a danger to patients, because surgery is where hospitals make their profits.”
15. “The lack of quality control. If you give the wrong treatment as a doctor, there aren’t many people who know enough to catch you.”
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16. “MD here. Clinical practice isn’t really evidence-based; a lot of things we do are mostly because it’s the way it’s always been done. There’s so much we don’t know about medicine, and most of the time we make educated guesses. Most diagnoses and treatment plans are risk-benefit analyses of probabilities with a significant error rate. We are just not that good at medicine yet.”
“There’s a large discrepancy in the public’s expectation of how accurate we are and the reality. I think in 100 years, we will look back on the ‘outdated’ way we currently practice medicine, even in our best institutions. To give an example, the best treatment we have figured out for resistant depression is shocking our patients; it works well, and it’s one of the best we have.”
And finally…17. “The dark reality of medicine is the insipid political intrigue that goes on that sabotages care for the advancement, wealth, and ego of powerful doctors. This means that as a young physician, you have to take orders from seniors even when they have no idea what they’re doing — and even when their actions threaten patients’ welfare. It also means that, to advance to a level of respect where you can actually practice medicine, as opposed to just doing what everyone wants you to do, you have to obsequiously defer to the establishment to bide your time, even if that establishment consists of dullards who only got their position of authority through patronage of some other powerful authority.”
“I’m finally at a level of respect in my profession, critical care, where I can mostly afford to practice as I think best, but it’s taken me years to get there, as I looked the other way and let people have their way that shouldn’t be allowed. This reality exists for many professions, but in medicine, it threatens lives and isn’t just petty jealousy. There is no meritocracy. You just have to learn to play the game.”
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Note: Some submissions have been edited for length and/or clarity.
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