"The Space Between
The wicked lies we tell
And hope to keep safe from the pain" ~Dave Matthews Band
In medicine the contract used to be between the physician and patient. If the patient had a disease X and went to a doctor to get relief from it. The doctor would prescribe a procedure/medication/encouragement Y, the contract was fulfilled when the transaction was completed. Those were simpler times.
The wicked lies we tell
And hope to keep safe from the pain" ~Dave Matthews Band
In medicine the contract used to be between the physician and patient. If the patient had a disease X and went to a doctor to get relief from it. The doctor would prescribe a procedure/medication/encouragement Y, the contract was fulfilled when the transaction was completed. Those were simpler times.
Today the space between the physician and the patient is
littered with intermediaries. The straight-line of care between the physician
and patient has been disrupted. Everyone is an expert trying to angle into the
game. This angling increases the gulf between the two parties. The current dictates
cover what the physician can or cannot do and what the patient can or cannot
receive in terms of care and what the government/insurer will or will not pay for those services to the
physician.
The Complexity of interactions within the Healthcare System of Medical Care
(If unable to view clearly please ask and I will send you a larger .pdf file)
A legion of experts devotes an inordinate amount of time to
make itself known and considered useful in maintaining its place as arbiters of
such a contract and to fill the space in between. These experts exact a price from the heath-care system and
cast aspersions if necessary, on the physicians and when able through tongue
and cheek at the patients as well. The emotional contract between the two
parties has been reduced to a binary value for the experts to claim the defect
in the care rendered using a set of arbitrary and capricious probability
assumptions.
The market forces of supply and demand work admirably in
business and they also work equally well in health care settings, if allowed. A competent
doctor is rewarded with patients seeking his or her help. Yet in today’s
climate the patient seeks out those doctors that accept insurance. This sets up
a “mill” or an assembly-line of sorts and quality is sacrificed for
quantity. Time is at a premium and eye
to eye contact is marginalized. Enter the EMR system, which further alienates.
The real understanding of the disease stems not from the cut, copy and pasted
14-paged document for insurance reimbursement but in the single expression of
the malady in a patient’s face.
The multitude of forces that compete within the sphere of
the patient physician relationship are increasing daily and advancing their
cause to the detriment of the patient-care. Something needs to be done.
Something will have to give!
The current zeitgeist circulating the society and reinforced
by the governmental and insurance industry is that medical care is a right. Is
it? Healthcare costs sky rocket because of overuse of the system. Maybe it is
time to reinvent the paradigm of developing the concept of “skin in the game,”
and not of, it is ours for free, go get a prescription. Maybe it is time for
some hard lessons and education. Maybe it is about lifestyles against chronic
illnesses. Maybe it is about
understanding after all.
Dave Matthews Band...Enjoy!
http://youtu.be/H67uEgRZs2Y
Dave Matthews Band...Enjoy!
http://youtu.be/H67uEgRZs2Y
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