The Side Effects Of Practicing in the Medical Industrial Complex

The Side Effects Of Practicing in the Medical Industrial Complex

By Russell Mokhiber of Corporate Crime Reporter.

An interview with Michael Milligan.

A recent Mayo Clinic study found that more than half of physicians in America struggle with burnout.

Playwright Michael Milligan spent the last couple years asking doctors around the country “why?”

In his new play, Side Effects, Milligan shares the answers he received through the fictionalized account of one doctor’s struggle.

No one ever told Dr. William MacQueen about the side effects of practicing medicine.

As bureaucratic and financial pressures collide with his professional standards, William must reconcile the art and business of medicine.

In 2013, Milligan toured with Mercy Killers — his first one man play about the healthcare system.
Mercy Killers is about a libertarian car mechanic whose wife gets sick and things quickly go downhill. Mercy Killers takes place in the interrogation room of a police station.

Milligan took Mercy Killers to community theaters and even smaller community spaces around the country.

The audiences were brought to tears. At the end of the play, Milligan engaged with the audience and then passed the hat.

Milligan brought in a couple of hundred dollars a play — enough to get him to the next town.

What is the new play – Side Effects – about?

“Side Effects is about a physician struggling to balance the art and business of medicine,” Milligan told Corporate Crime Reporter in an interview last week. “It’s a doctor struggling with burnout, which is a real crisis in America — up there with the opioid crisis. Was it last year or the year before that the Surgeon General came out with a statement on opioid addiction and physician burnout?

The play explores why physicians are burning out. It also raises questions about the quality of care. Does physician burnout affect doctors’ ability to give a high standard of care?”

Your plays are political. You are allying yourself with the single payer movement. There was a vote just last month on the Senate floor on single payer. There are 115 members of the House who are co-sponsors of the single payer bill HR 676. Bernie Sanders is going to introduce a single payer bill in the Senate.

What are your thoughts on the intersection between art and politics?

“With Mercy Killers, I did a tour of Texas. It was there that I first started to do my interviews for Side Effects. Texas is a place of so many different contradictions. I experienced an incapacity to control an audience response to the work.”

“I knew I wanted Mercy Killers to have this effect on the audience and result in people moving toward a certain direction. People took their own response from it. I had people who were absolutely crazy about the play, they loved it, but they felt it was about the erosion of the middle class. Some guy said — you need to get this on PBS, it’s terrible what’s happening to the middle class.”

“And I said — what’s the solution?”

“And he said — repeal Obamacare.”

“And I said — how did you get that from my play?”

“I had this interesting experience. I was on my day off down in Texas. I was at a grocery store. It was a Latino grocery store. There was a barber shop set up where the pharmacist used to be. In that guy’s window he had a jar with a note that said — Obamacare Penalty Fund.”

“In my travels, I wanted to hear what everyone has to say about the healthcare system. I went in and sat down in the chair and I said — tell me about that jar you have in that window.”

“And he said — yeah, I can’t afford health insurance. And I have to pay the penalty.”

“I don’t know what his financial situation is. Did he go on the web site and see what kind of subsidy he could get? What I discovered is that it’s very different in every state. And people’s experience is different in every state. A Republican legislature may or may not want Obamacare to work. But what the barber said made sense. He said — if I buy the insurance, I won’t be able to afford to go to the doctor.”

“I asked — how do you go to the doctor?”

“And he said — I go now to a community clinic and pay on a sliding scale.”

“I ask — what is the solution?”

“And he says — I don’t know but I don’t think the government has the solution.”

“About three minutes go by and then he says to me — did you ever see that Michael Moore movie Sicko?”

“I said — yeah.”

“And he said — it was kind of interesting how they had things set up in Cuba. Maybe something like that could work here.”

There is confusion. Many in the single payer movement fought Obamacare because it kept the insurance industry at the center of the system.

Does the pharmaceutical industry play a role in Mercy Killers and Side Effects?

“There is more of that in Mercy Killers. Side Effects is more about all of the bureaucracy — the corporate insurance bureaucracy, fractured entitlement bureaucracy — all of the things eating up doctors’ time — the things that are taking away from actual patient interaction. Also, the loss of autonomy that the doctor is experiencing.”

You said that Mercy Killers is agenda driven. Is Side Effects agenda driven?

“With Side Effects, I approached it a bit differently. There might be more objectivity in Side Effects. I just interviewed doctors. I didn’t know what the subject matter was going to be. I just opened myself up to reading everything I could about the subject, talking to as many doctors as a I could — and then letting the play story form itself. My feeling now is — if I can present as truthful a reflection to the community of what is happening, that is my job as the artist. That will lead to the dialogue that needs to happen. As a single payer proponent, I don’t need to write propaganda. I just need to show the truth. It’s not like we are making something up.”

“This is why I’m so excited to be performing for doctors and nurses. Side Effects allows doctors to see themselves in the mirror. And it gives them a language that they are not familiar with. The play speaks in a language of emotion and symbolism that will let them recognize what they are experiencing in their profession. And most importantly the cost on them personally and the cost on their ability to practice the art of medicine.”

“As medicine becomes more and more consolidated, as fewer and fewer corporations own larger and larger parts of our healthcare system, the reality is that doctors more and more are becoming employees, or workers. And that’s a word they are unfamiliar with. The history of medicine in America is — medicine is a profession. It’s above the fray. But more and more that just isn’t true. My feeling is that when providers recognize the situation they are in, there becomes a potential for them to organize. Doctors are very smart and overall ethically minded decent human beings. It’s just that they haven’t been afforded the time to consider their role as citizens.”

“When I do talkbacks, I want to get along with everyone. That’s my nature. I try to talk differently to different people. I try to speak people’s language. People are not as educated about other countries’ healthcare systems. For a certain segment of people who are for single payer, what they mean is they want universal healthcare. If you said — okay, we are going to have Germany, or Australia, or the UK, or France — or something else — they say — yes.”

Is Side Effects going to be the same as with Mercy Killers — you do the performance and pass the hat?

“It can be. But I was invited to a college in Vermont and performed it there. I presented it at the Mayo Clinic last fall. If I present it at the Mayo Clinic, I don’t ask them to pass the hat. They pay me up front.”

“But in New York, I did a three week run where it was pay what you want.”

“And this fall, I’m going to do a five week run here in Chicago where all of the tickets will be pick your own price. It will be at the Greenhouse Theater Center.”

You were in Washington DC with it where it was a $15 ticket.

“Yes. That was produced by a theater and part of their mission is to make theater accessible.”

“But I want to go even further than that. I’m launching a theater company in the fall that encapsulates this model — The Poor Box Theater. It’s about doing hard hitting plays about issues that affect people. I want everybody to be able to see the play. I don’t want anyone to not be able to see the play because they can’t afford a ticket. That’s a part of the launching of this play. I’m curious about if it is going to work as a model.”

“I think it is. I’ve reached out to the Illinois Single Payer Coalition, Physicians for a National Health Program. And people are receptive to that model. I’ve collaborated with those organizations in the past. They are familiar with Mercy Killers. And they are excited and supportive of this project.”

“If we are fighting for the idea that everybody should have access to healthcare, let’s expand that to everybody ought to have access to the arts. That’s a powerful synergy between those two ideas. And I’m excited about seeing what happens in the fall.”

[For the complete q/a format Interview with Michael Milligan, see 31 Corporate Crime Reporter 32(13), August 21, 2017, print edition only.]

 

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