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Quick summary: Debra Blaine, MD, discusses how medicine is now just another corporate entity, operating as a profit-centered business instead of an essential human service.

Too often, the venture capitalists who own and manage health insurance companies, hospital systems, and pharmaceutical companies, have neither knowledge nor prurient interest in human physiology and psychology, and yet, they create the algorithms by which care is provided.

Our current system treats medicine as a commodity, not as an essential service. We the people are preyed upon by tycoons who wish to sell their services, and for whom quality control is not a moral directive but a necessary expense. There is no acknowledgement of the sanctity of human life and caring for humans has become equivalent to manufacturing microchips. We are so entrenched in the corporatized milieu, that our predicament seems daunting at best. Obviously the math has to work out and services need to be paid for, but what can we do differently, and how can we adjust our course?

An important first step would be to equalize reimbursements from insurers, and to allow any qualified physician to be able to collect from their patient’s insurance company for services rendered. Instead, the decreased “negotiating power” of small group practices has been a catalyst in forcing physicians to buy into corporate systems. Currently, a service performed by a cardiologist in a solo practice earns him a fraction of the reimbursement provided to another cardiologist for the same service in a large group practice. This discriminatory nature of insurance companies has shepherded physicians into large corporate systems in order to survive because the individual doctors cannot afford to support their practices on the remittances they receive. It has also impelled patients to leave doctors who have known them for years and who understand their health nuances.

 

This discriminatory nature of insurance companies has shepherded physicians into large corporate systems in order to survive because the individual doctors cannot afford to support their practices on the remittances they receive. Click To Tweet

 

In addition, complex administrative requirements have been artificially increased to satisfy companies that have no understanding of what it really means to care for human beings, and these have necessitated hiring additional staff just to code and submit records for payments. This further constitutes a financial burden on a small or solo practice. Too large a percentage of the cost of providing medical care has nothing at all to do with diagnosis and treatment. Medicine has been forced into a corporate business model.

If each physician were to receive the same payment for the same service, and needed to pay salaries only to those competent individuals who contribute to the quality treatment of patients, large corporate structures would not be able to force physicians to maintain that company’s standards of high levels of “productivity” (i.e., volume of patients per day), nor would doctors be judged and penalized by surveys in which the patient may downgrade the practice because an inappropriate antibiotic was correctly not prescribed for a cold, or the coffee creamer selection in the waiting room was not to a patient’s liking. Patients would likewise be able to stay with the doctor who knows them well, and reestablish long-term relationships built on trust, camaraderie, and mutual respect.

 

We the people are preyed upon by tycoons who wish to sell their services, and for whom quality control is not a moral directive but a necessary expense. There is no acknowledgement of the sanctity of human life and caring for humans has… Click To Tweet

 

Corporate medicine, in true adherence to the business model, typically sends customer satisfaction surveys to all patients. Patients are invited to criticize the care they receive, and this shifts the priority of treatment from healing the patient to pleasing them instead. And all the while, the whip is being flogged on the doctor to see more patients, code more procedures, and move patients along more quickly. All to the ultimate goal of increased revenue. Is it any wonder that physicians are experiencing burnout and depression, and have the highest rate of suicide per capita than any other profession in the US? [1]

I fear that if we do not address these issues at their roots, we will soon no longer be able to expect anyone to invest eleven to fourteen years after high school and a half to three-quarters of a million dollars training to become a physician. In their place, we will have physician assistants and nurse practitioners exclusively, with no access to an experienced doctor for consultation; good people but with markedly less experience, training, and acumen. America will still have the “product” of excellent medicine without the means to “distribute” it. Thus, ultimately, the current business model, as applied to health, will fail. But how many humans will have to die or suffer unnecessary morbidity before that happens?

 

The current business model, as applied to health, will fail. But how many humans will have to die or suffer unnecessary morbidity before that happens? #medtwitter Click To Tweet

 

It is not that we do not have the financial resources to provide appropriate care, they are just being rerouted into the pockets of large corporate holders. Human life is being forfeited for the sake of the profit margin, and it is being done “legally.” How much is it worth to save a life? How is this not human trafficking?

[1] Medscape National Physician Burnout, Depression, and Suicide Report 2019

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Debra Blaine, MD

Novelist. Speaker. Life Coach. Urgent Care Physician

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