Sometimes it’s hard to not lose hope. The American health system is so broken. The MBAs seem to have won. The patient is too often no longer the focus. It’s now the bottom line. I suspect a fair number of practitioners are caught in the middle. Quite likely too much focus on the patient means the loss of a job. I sent this article to my sister who is an emergency room nurse in southern California. She said she nearly cried when she read it. But as she said, “What can you do?” It was a rhetorical question. Then she told me that many of the nurses she knows are going back to school to become psychiatric nurse practitioners. What they tell her is chilling: ” I am going to work in [so and so’s] office. A patient will come in and I’ll ask, ‘How are you doing? How’s the medication working?’ Then I’ll write them a script and say, ‘Okay, I’ll see you in 2 months.’ In 5 minutes they’ll be out of my office. I’ll make so much money! I’ll never really have to see patients, just write scripts!” One can only hope that sooner rather than later the bottom falls out of the whole racket. I think it’s criminal. We must continue to speak up and speak out. If enough of us do so, at some point our collective voices will be heard.