Everyone has heard this pithy saying. We may or may not be able to apply this to our personal lives. But why is our government not capable of applying this saying to our national healthcare.
All of us have heard that other industrialized nations like Canada and Britain achieve better healthcare for their populations with less money. Certainly the problem is very complicated but the simple approach of prevention seems to be largely overlooked and under-incentivized at a national level. Let me explain.
Lets consider Primary Care medicine which largely includes Family Physicians, Pediatricians and Internists. These healthcare practitioners promote patient-centered care (as opposed to disease centered care) as a matter of practice and training. In other words they are trying to take care of the whole patient, not just a single disease. In fact, the University of Utah Health Sciences (from which VisualShare emerged) Department for Family Medicine is called "Department of Family and Preventive Medicine".
I have read a number of articles from professional medicine journals to national newspapers that cite the decreased enrollment in these specialties, especially Family Medicine. Moreover, these articles cite a 10% inflation adjusted decrease in Family Physician income. It is worth mentioning that Family Physicians in general are the lowest paid MD group.
So, we have a low-cost solution to healthcare that promotes prevention to save a pound of cure. Sounds like a bargain, right? Yet, our government, insurance providers and consumes to some degree choose the higher cost solution that leads--via lack of prevention--to more costs down the road.
Sounds like a ripoff, right? It is no wonder we are burdened by such large healthcare costs. Other industrialized nations utilize primary care specialties nearly 20% more than the United States.
So, my conclusion is that we, as nation, do not need so called "healthcare reform" (outlined in 1000's page proposals that rarely make it to the floor of Congress), we simply need to encourage (incentivize) the use of primary care physicians for our healthcare services when possible. This would drive down costs in the short run as they are a less expensive alternative (in some cases) and it would drive the long term costs down because we would get a "pound of cure" for our "ounce of prevention"--a multiplier on our healthcare buck. Such an efficient application of resources may or may not increase supply of primary care physicians. Certainly if there is more demand, supply will follow if Mr. Market is at work.
The fact that we are not efficiently utilizing the nation's dwindling primary care physicians tells us that Mr. Market is not at work. Some other force is. What could that force be?
I will not claim that I understand the political machine, but it is clear to me that insurance companies and medical specialties other than primary care stand to benefit from the status quo while the taxpayers continue to pay for the excessive costs of not practicing "An ounce of prevention is worth a pound of cure".
This issue is of relevance to VisualShare because one of our markets is healthcare imaging and we work closely with primary care practitioners as well as specialists.
Comments (1)
Great post and definitely relevant to VisualShare’s mission to provide telehealth applications that support the consultation needs of providers in any medical specialty.
Along with the Federal Government’s role in defining a national healthcare standard much less reform the insurance companies that are structured to support specialty physicians within their referral networks and design healthcare plans that force consumers to take a much more expensive route to obtaining healthcare. One should not ignore the role of pharmaceutical companies in the equation, which is another tangent altogether. How often does one get asked the question “Who is your primary care or family physician?” and how often the response is “I don’t have a regular primary care physician, I go to the network of clinics that is part of my insurance plan”.
This brings up another very important topic, one of education. We are ultimately responsible for making decisions about our healthcare and human maintenance. How many people know the role of a primary care and family practice physicians? How many people visit a doctor’s office with a sick child and expect to get a prescription for antibiotics when antibiotics are not necessary? Or understand what it means to treat the person as a whole and not just the disease? A good example of human maintenance is the well baby checkup. Pediatricians are primary care physicians specially trained to treat and maintain babies. We regularly take our babies in for these very important checkups. For that matter, adults also get regular checkups often called a physical but many times we get busy with daily life and lump a physical with a routine exam to save time. Were we even aware that primary care and family practice physicians can provide essentially the same service as part of overall human maintenance? My guess is maybe not because the path to getting that information has many forks in the road and we often don’t have enough time to find the right fork.
There are other unknown or unforeseen barriers in the healthcare picture. For one, many people (yes, the very same people mentioned above) live in rural communities that have limited services. How often do those very same people travel to seek healthcare fro a problem that could have been addressed if information about the problem could have been shared with an expert without having the patient travel. For example, premature newborn children that require screening for retinopathy of prematurity (see ROP entry)? Transporting a new born child is stressful for the child, parents and family members not to mention expensive. Or a computed tomography (CT) image that shows a benign congenital cyst that has undergone treatment with months of antibiotics with no change and is removed by a general surgeon in a rural community hospital? All because the primary care/family practice physician was able to conduct a consultation and view the CT at the same time with the surgeon at the community hospital where the patient resides?
We are responsible for our healthcare and human maintenance. We need to make educated decisions for ourselves and take action to change the way healthcare is managed! It all starts at the grass roots level so let's do something about it!
Posted by Patricia Goede | March 14, 2007 2:40 PM
Posted on March 14, 2007 14:40