Doctor-Patient Relationship (#56)
Seeing a doctor is not like going out to buy something. It involves a whole range of issues that hinge heavily on trust, personal responsibility, and ongoing maintenance. The nature of this relationship has not changed much until about 50 years ago with the rise of drug manufacturers, hospitals, and insurance companies, which are for-profit corporations. This is brought about by the development of medical technology. We also saw governments in many countries taking over the health care business.
The traditional relationship between doctor and patient still remains strong in many non-Western countries, especially in the Chinese countryside where ancient Chinese medicine is practiced. However, health care cannot escape the inevitable changes brought about by modern technology. The problem is not how much we dislike the change, but how best we can make it serve the community.
The traditional relationship between doctor and patient has been largely destroyed in modern days. The following is a description of what has happened:
Payment and Price
Up to the 1950s, people paid out of pocket when they visited a doctor, except for a big operation where they might get help from the government or somewhere else. When you pay with your money, you tend to negotiate the price down and you dont overuse the service. The doctor cannot charge too high a price for fear of driving the patient out the door.
Medical insurance changes all that. Just like an all-you-can-eat buffet with a fixed price, the patient tends to overuse the medical service for the fixed amounts he pays the insurer as premiums. The doctor wants to charge the highest price that the insurer can accept. This results in higher costs. Moreover, both the patient and doctor relinquish their rights to negotiate for the best price. The insurer becomes the final arbiter besides being middleman. It will set a price that maximizes profit without regard to the interests of either doctor or patient.
Thus, the doctor does not practice ethics because he wants to charge the highest price. He also wants to make the patient come often for more insurance payments. The patient must settle for less service than he wants. He has to pay for what the insurer refuses to cover. As a consequence, medical insurance destroys personal responsibilities inherent in doctors and patients. It results in higher medical costs, more profits for insurers and doctors, and higher premiums and out-of-pocket costs for patients.
Quality vs. Quantity
Do you think you are getting better quality now than prior to the 1950s? In those days, doctors still made house calls. Furthermore, when you consulted a doctor, he would not ask you to fill out an insurance form at the door. He would invite you in and asked about your problems.
Nowadays, we have all kinds of new medical technology and wonder drugs that have the potential to better our lives. How far are we from this lofty goal? Modern medicine comes with a high price attached that only the rich can afford. It benefits only a small segment of the general public because the government, charity, or insurance agrees to pay for the high cost.
Modern health care has sophisticated technology. The missing dimensions are: care and ethics on the part of the doctor, self-responsibility on the part of the patient, and mutual cooperation for prevention and good health maintenance. Good health care does not have to be expensive. It must achieve physical and mental wellness for the majority of the population.
Over-Testing & Over-Prescription
The payment system for doctor carries a misguided incentive: fee for service instead of a fixed salary. Doctors are paid extra for the tests they order and the drugs they prescribe. This results are over-testing and over-prescription. There is a better model to follow that attracts national attention: Mayo Clinic in Rochester, Minnesota. This clinic operates at a much lower cost than the national average because they have a different pay system for staff members.
Technical Details & Scare Tactics
Maintaining good health is not complicated if you use your common sense. However, health care providers tend to add complexity to boost their image. The worst part is to use scare tactics. Have you seen all the technical stuff and scare tactics out there? When people talk about health these days, the conversations are full of technical jargons. Does it have to be that way?
www.herbsandtea.com
July 2009
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Vitals For Doctors - Patient Acquisition and Patient Advertisingby vitalscom1,277 views
most doctors are self serving people.
lewiable 3 days ago