One doctor’s thoughts on healthcare costs, quality, and overspecialization; a must-read.

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rising healthcare costs Any of you who may have had a problem in the past requiring hospitalization can likely relate to this doctor's article. You are poked, prodded, visited by numerous people in white jackets with stethoscopes that are supposed to be helping you and figuring out your problem. Part of the problem is that they only look at a small part of you, rather than you as a whole person. The other part is of course, they will order tests and diagnose whether or not the outcome of the test will yield to appropriate intervention, especially in the elderly. Your insurance has become a cash ticket for the business of medicine to over-diagnose, over-treat and underperform. The body consists of systems and organs that interact via hormones and the nervous system as well as the circulatory system. Years ago, your doctor would spend the time to help diagnose and figure out your problem. While there was always a huge void in their knowledge base because of their marginal training in the musculoskeletal system, a role being filled by physical therapists and chiropractors mostly, they often would be able to help you with your problem. In the 1960s, the march toward specialization resulted in doctors who no longer looked at you, but looked at your organs, your parts, your system rather than your systems and how they integrate and resulted in today's system of super specialists, high costs, and a system that is bloated and inefficient. Gone are the days where most doctors will spend the time simply because they cannot afford to, thanks to insurance company reimbursement policies. The result is a poorly coordinated system that no longer looks at you, or has a relationship with you or your family. It has become the business of medicine, giving us the business. One doctor who recently wrote this op-ed piece for Time magazine is clearly frustrated (as he should be), because many doctors still care, and are appalled at what they now see as their profession and the machine it has become. Check out this doctors article One Patient, Too Many Doctors: The Terrible Expense of Overspecialization  

As physicians become more specialized, our health care system becomes increasingly costly, sloppy, and disorganized

Not long ago, a primary-care physician called me about a patient with a right-lung "consolidation" — probably pneumonia, though a tumor could not be excluded — that a lung specialist had decided to biopsy. My colleague wanted me to provide "cardiac clearance" for the procedure. "Sure, I'll see him," I said, sitting in my office. "How old is he?" "Ninety-two." I stopped what I was doing. "Ninety-two? And they want to do a biopsy?" My colleague, who is from Nigeria, started laughing. "What can I tell you? In my country, we would leave him alone, but this is America, my friend." Though accurate data is lacking, the overuse of health care services in this country probably costs hundreds of billions of dollars each year out of the $3 trillion that Americans spend on health. This overuse is driven by many forces: "defensive" medicine by doctors trying to avoid lawsuits, a reluctance on the part of doctors and patients to accept diagnostic uncertainty (thus leading to more tests), lack of consensus about which treatments are effective, and the pervading belief that newer, more expensive drugs and technology are better. However, perhaps the most important factor is the overspecialization of the American physician workforce and the high frequency with which these specialists are called by primary-care physicians for help. read more