Healthcare Reform

DD1D526C-043A-452C-9493-AE7E8CDF2B08Healthcare Reform

Today I read an article about how the high cost of our healthcare relative to other countries primarily results from the higher cost of pharmaceuticals, insurance companies and administrations. Certainly I feel validated in my long-standing beliefs. But the complexities of our system, considering the expectations and entitlements coupled with liability fears, make solutions seemingly impossible. Earlier this week, one patient who was prominent in the community, expected special treatment because of his social status. Another patient who is totally noncompliant with medical advice expected special treatment because of his sense of entitlement. Adding to the problem, the medical system has prioritized patient satisfaction over quality and allows patients to make poor decisions with little resistance from the physician because of the fear of low patient satisfaction survey scores, which adversely affect reimbursement. Many of us physicians with great ideas are squelched because we represent good patient care over this bureaucracy; and, in case there is any question, WE are not in charge anymore.

Naivety

F4615B3D-4497-476B-8BD7-8DFC6A2A475FNaivety

Naivety is having or showing a lack of experience or understanding. This definition of the word came to mind as I read my medical “news” today. Medicare is preparing to “improve patient care” by implementing a new reimbursement plan that will cut their payments for healthcare providers. Sadly enough, most people won’t question such a “noble cause.” Perhaps we can improve other entities using this same philosophy. I suggest we start with the federal government and cut their salaries to improve their work—how can they argue with their own rationale?? Sorry, I am being naive.

Scientific Evidence

8C2B1DB7-D895-41B8-8DC6-3CAE20AB66CBScientific Evidence

Having been in healthcare since 1981, I have witnessed some amazing changes as to what qualifies as scientific evidence. Our media is flooded with claims, supported by various “studies”, about all sorts of things. Often the studies are not statistically significant, but reported with “authority”. Unfortunately even our “best” medical ones are often fraught with bias and deception. I believe healthcare needs reform starting with pre-medical training with a commitment to excellent patient care. It seems to me our broken healthcare system cannot be fixed without starting at the foundation and rebuilding, actually training a new generation of critically astute physicians less biased by money and special interests.

Mindfulness

BD26BEE9-D817-4025-BD1B-7343FEF0B247Mindfulness is a technique developed in 1979 for relaxation and stress reduction. Since that time, the number of articles devoted to mindfulness has grown exponentially such that by 2025, potentially all medical articles will be on mindfulness. It is nearly impossible to get through medical training without multiple lectures/courses on mindfulness. Perhaps if physicians are focused on mindfulness, they will not notice what is happening to healthcare.

Layers

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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.

Physician Shortage??

88C87311-814C-487F-924F-7A7652E5F908.jpegDo we have a physician shortage? Like so many areas of healthcare, the answer is not straightforward or clear. I personally believe we do NOT have a shortage of physicians; instead, there is a lack of good distribution and efficiency.  The legal and administrative demands on physicians have limited their ability to care for the numbers of patients they should easily manage with a more common sense approach. The responses to a perceived shortage seem dangerous to me. For example, we have increased the number of medical students in school, but their clinical experience and training often suffer. It seems we are generating physicians and not educating them sometimes. I believe we have set sail on a treacherous course in healthcare and the strong winds of  overregulation are blowing us away. We need practicing physicians at the helm. Too often, physician input comes from those hired by the government, hospitals and insurance companies.