Questions and Observations

This interview, soon to be forgotten by most who see it and probably unseen by the majority of the country, is a very important and significant interview.

Watch it carefully, because Dr. Louis MacIntyre is about to lay out our future health care system for everyone (for whatever reason the “embed” link is not cooperating, so I’ve linked it).

Three things jump out at you.  One: the fact that costs for insurance and regulatory compliance are rising while reimbursement is dropping has doctors being forced into looking at an entirely new model for health care.

Where now, it is marginally patient centered, the “improvements” are going to drive them and the system to a more process centered care.  Think VA hospital vs. private care.  In a VA hospital the physicians work for the VA.  They are, by contract, required to do things the VA way, even if those things they do don’t necessarily represent the best care for the patient.

In private practice, doctors are “outcome driven” vs. process driven.  Hence they work within standard treatment parameters to address the patients problem but are free to try other methods that are indicated via their training and experience.  We’re headed into a “process driven” environment.

Two: as the costs rise and more and more doctors are driven from private practice, they’ll seek employment in hospitals.   They will then, as Dr. McIntyre notes, unionize to protect their compensation from dropping rates of reimbursement (remember, that’s supposedly one of the driving concerns of reform).  They will then go from being a “profession” to a “trade association”.  And that trade association’s focus will not be patient advocacy, but instead, trade advocacy.

Three: left out of all of this “sea change” that is likely to happen?  The patient.  You.  Your choices are going to be limited.  You’ll have very little to no say in a process driven environment.  And the chances of an actual relationship with a doctor who will intimately know your case are virtually non-existent if, in fact, we end up with a system of VA like hospital care centers. 

Consider all of that carefully.  Then ask yourself this: what bright and talented person, knowing that was the environment they’d have to commit themselves too, would willingly spend the years necessary to obtain an MD just to become an employee of a hospital and not allowed to use any creativity or experience (or anything outside the processes protocols) to treat patients?

Yeah, not many.

But, don’t forget – health care will be “better” and “less costly” because government says so.

~McQ

Twitter: @McQandO