Imagine this: you walk into your doctor’s office expecting care based on your needs, symptoms, and medical history. But what if that doctor isn’t really working for you? What if their decisions—about your pain, your medications, your safety—are shaped not by best practices, but by the invisible policies of a health system more focused on optics than outcomes?

This isn’t hypothetical. Across the country, doctors are facing mounting institutional pressure to reduce opioid prescriptions—no matter the cost to their patients. Hospitals like UC Davis Health enforce policies that reward tapering, penalize caution, and turn collaboration into compliance. The result? Doctors are no longer free to make the best decisions for the patient in front of them. Instead, they’re forced to make the safest choice for the institution.

They aren’t treating pain—they’re managing liability.

And when that happens, the question becomes: whose side is your doctor really on?

Let’s be clear. Many doctors do care. But the system they work in is built to punish good care when it doesn’t align with risk-averse metrics. They’re told to reduce doses, avoid terms like ‘chronic pain,’ and when necessary, label you with ‘suspected OUD’—even if there’s no clinical discussion or diagnosis. Why? Because it justifies a reduction. It protects the institution.

It doesn’t protect you.

You may be offered medications that don’t work, or worse, that cause serious harm—just because they appear ‘safer’ on a chart. Meanwhile, the treatment that actually helped? It’s taken away. Not because it stopped working. But because someone, somewhere, decided it looked bad on paper.

Is it unfortunate that doctors are under this pressure? Sure. But should we feel sorry for them when they follow harmful policies at the expense of the patient? Absolutely not.

The moment a physician chooses job security over patient well-being is the moment they stop practicing medicine—and start managing damage.

So if your doctor feels distant, defensive, or strangely robotic, you might not be imagining it. It’s not just you. It’s the system. And until that system is challenged, your doctor may no longer be your doctor at all.