Healthcare, One size fits all corporate medicine, Politics, Greed and Monopoly: The slippery slope
The popularity of smartphones and the ‘on-demand’ economy is pushing every service towards consumerism and personalized healthcare model is no exception. We cannot stop the deontological reform which is going to impact the physician practice model.
Healthcare is a lucrative industry and many entrepreneurs and investors cannot wait to have a slice of the pie! Some of the big corporate companies that their target market was anything but medicine are looking to profit out of healthcare- they are trying to take over the direct primary care market, getting access to healthcare savings accounts (HSA) and forming alliances with insurance companies- we are surely heading for a disaster!
Each and every company claims that they have the golden solution that physicians can use to reach their target. Some of them succeed at convincing the healthcare stakeholders but most of them fail! Many of them went out of business though some made quick millions in the wake of the hour and stayed on doing business. But none of them were able to maintain the independence of physician practice and guarantee patients that their information is safe and secure.
Surely they did not earn the trust of both patients and physicians and even discouraged the investors who always look out for a fully functional prototype to make up their mind.
We are Facing the Consequence of Past Experiences
Healthcare is riddled with various negative factors such as distrust, pessimism and failure. We have been left with a bad taste in our mouth because of the past experiences. Those experiences have to be blamed for the present poorly designed solutions, validations, monopoly and politics. Unless you are a big corporation backed by politicians, you cannot realize the true solutions and promote the real talents- the market is too big for that!
Only “Physicians” have the golden solution but we are not able to implement it. We have been raising our voice year after year but is anyone ready to listen? Recently some primary physicians are moving to direct primary care (DPC) in a welcome change. If implemented correctly. DPS has the ability to create and validate personalized medicine. But we have to keep the DPC practices independent and small in size to achieve the mission it set out on.
But such a change seems farfetched with large corporations and retail chains trying the grab a piece of the healthcare pie! And that has led to all the problems.
Where did We Go Wrong?
Healthcare has become a political issue and we have been made to believe it must be paid by third party because it is expensive. We have created a monopoly with big corporate companies engaging in under the table deals, pushing and lobbying for their own prices. They have no standards and are not held accountable, which is utterly wrong! We need accountability and responsibility when something goes wrong — and we need it to be done right. We don’t want scapegoats to be made out of the entire process. Rather, we need comprehensive standards and guidelines and ensure that everyone follows it.
The present scenario limits the physician’s ability to form clinical judgment and reduces his ability to prescribe medicines for best patient outcome. The government or insurance companies end up controlling the medicines we physicians can prescribe which is totally wrong.
We have been promoting the population based medicine when we should have been stressing on personalized medicine. We have developed a “corporate mentality of one size fits all” that doesn’t apply to healthcare. Patients and the general public have led to wrongly believe that only large systems can deliver cost effective care.
Most of all we have been wrong in staying passive but we need to overcome pessimism and speak out.
Where does the Answer Lie?
The corporate entities are currently reigning over 3 healthcare pipelines- physician reimbursement, patient drug prices and lobbying interests through politicians and the government. DPC can be utilized to solve only one of the pipelines but the other two will be unaffected until DPC gains traction. The journey is going to be rough but we have to reach the destination anyhow!
Healthcare has been intentionally turned into politics and patients have been made to believe only government can solve the problem. Corporate greed has mixed into this politics to make matters worse. We are encountering massive monopoly with pharmacies merging with insurance providers. Online retailers are buying out independent pharmacies and the HSA of patients are up for compromise.
Amidst all of these, Atul Gawande is now heading the Amazon Healthcare project and also leading interests of Berkshire Hathaway and JP Morgan Chase. But prior in his career his heart was on the ideal- he volunteered for Gary Hart’s campaign in his undergraduate days and campaigned for Al Gore in 1988. He also took the role of a healthcare researcher for Rep. Jim Cooper but had to bow to corporate pressure it seems!
We have been blindfolded for too long with useless solutions and mandates but now time has come to listen to the feedback of doctors and physicians. We physicians need to embrace the change and collaborate to save our independence. We have to find enough time to dedicate to the patients while leaving room for adopting the necessary technologies for better care delivery without compromising health information privacy.
If we have to have a place for corporate companies, they should be the ones to support physician interests without jeopardizing their independence. We have to move towards total transparency and understand the value of patient-doctor relationships. The government will have to listen to our needs even if 1% physicians are able to support 1% of their patients.
Ultimately we have to empower doctors, patients and every stakeholder in the healthcare industry.