Healthcare Bleeding

1F70F747-DA52-4AFB-9771-F7F334C8B928Healthcare Bleeding

Our healthcare system is truly in a crisis. Most people in the field or using the services clearly see how broken it has become. In effect, the system is “bleeding” money away from patient care and into a vast bureaucracy. A recent study shows that the biggest cost increases have come from insurance companies, pharmaceuticals, and administrations. Physicians, although commonly blamed, do not substantially contribute to the rise in costs directly. Having been in the field since 1981, I am appalled at the attack on physicians from multiple fronts, mainly legal through continued legislation that only adds to costs and derails patient care. We have become hired “guns” and they are looking for cheaper ones; hence, a flooding of poorly trained, mass produced physicians and mid level providers will assume the reigns of seasoned physicians who are leaving the field prematurely, during their peak productive years. I don’t see an easy answer, but am open to suggestions.

Compliance

A81D3E8A-6396-454F-8A19-430D8F126432“Better was a poor and wise youth than an old and foolish king who no longer knew how to take advice.”
‭‭Ecclesiastes‬ ‭4:13‬ ‭ESV‬‬

Compliance

My friend in the insurance industry and I discussed the relatively recent emphasis on compliance in our respective businesses and concluded that all the associated added expenses of mandated compliance have added virtually nothing to society except excess costs. Certainly I have seen so much government regulation in healthcare that is just ridiculous, another byproduct of too many lawyers. We allow non-medical people to decide what is “good” medicine, which always requires excessive documentation, documenting what I call ”e-garbage”, instead of medically relevant facts. And I can’t imagine how we plan to save years of electronic health records, since computers have made it so easy to generate volumes and volumes of senseless information. Of course, the electronic health records are astronomically expensive and have accounted for an increase in medical error deaths. Finally, while we have compliance departments that make sure we practice “good” medicine, we have far too few “hands on” patient care staff. Literally patients can bleed to death without anyone noticing while in a hospital intensive care unit, while the hospital is being compliant.

Ownership

E299B01A-12B9-4466-86E6-91898DC8AE76Ownership

When we have ownership in something, we definitely tend to take the best care of it. I have been renting my house out parttime and while most guests are good, some are clearly careless. I would never do some of these destructive things to my home.
I believe that we all need to take more ownership, especially in our country. Those who have to pay their way tend to limit their spending, but those who are not required to pay seem to have no concern for costs. We see this everyday in healthcare. Many people who have to pay will sacrifice their health to save money, while those not required to pay clog up the system. While I am happy to help anyone regardless of financial resources, the current system is not fair.

Law

Law
It seems to me our government has lost all perspective. Our Congress continues to make laws, perhaps in good faith, that add a tremendous financial burden to society without true benefits. For example, while there is no doubt we have a serious drug abuse problem in our country, will putting expensive restraints on the use of prescribed narcotics for pain solve it? I seriously doubt it. My friend just had a narcotic prescribed for severe pain from a shoulder injury and the drug screen required cost over $1000. (Whose lobbyist won that cash cow) Meanwhile there is a huge push to legalize marijuana. Congress can make these “trivial” laws, but cannot fix healthcare, education, or the economy. Perhaps a Presidential order or a Supreme Court ruling can intervene…who makes laws again??70444885-D7BA-4C15-876D-1513F78B2CE3.jpeg

Layers

EDA347EC-1A39-4ECE-A549-BCFBA50F0FDFLayers
When I think of layers, I generally think of the peeling off of layers of clothing or layers of skin. But today I read an amazing article (Physicians aren’t ‘burning out.’ They’re suffering from moral injury by Drs. Talbot and Dean) on the moral injury of physicians by a broken healthcare system. In my medical mind which has many years of experience, I believe the authors are exactly correct with their assessment. As this kind of honest information about physicians hits the media, I feel the first layers of this massive medical bureaucratic quagmire begin to peel—a glimmer of hope.