Too often these days, the healthcare industry is focused on data and metrics. Doctors’ salaries are determined by RVUs and reimbursements increasingly decided by numerical clinical outcomes. Under these models, the more patients seen, the better.
While P4P is touted as a good thing, it is driven by numbers as goals. Yes, medicine is a business but like no other because the human touch will always be needed. Yet, despite the need for personal care, the McMedicine Clinic seems to be the way of the future.
This morning, I spent more than 45 minutes with a patient discussing her abnormal brain MRI. It did not look good and likely she will go through a medical battle for her life. The patient greatly appreciated the time I spent with her but, if I were working in a different model than private practice, this extra time holds no value.
In McMedicine, there is no time for empathy.
In fact, McMedicine is driven by a desire to capture revenue. This is why an increasing number of doctors are leaving private practice: we are not educated to run a business.
But, McMedicine executives are and they will control the clinics of the future. Doctors will exist purely for the money they generate. Patients will be customers that purchase the services. More clinics are offering more and more services: many of them simply are not needed but do pay well.
Speed is a key ingredient in our future world of medicine. Need a flu shot: use the drive thru. We are already seeing much assembly line, take a number medicine. Many patients complain that they wait too long to see a doctor. But, is the alternative a better fix?
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
In the medical world of the future, patients don’t even need to leave their computers for many ailments: Skype-a-doc will come to the rescue. And many will cheer its roll-out because it will save time.
But what about the consequences? Is it really wise to replace an otoscopic exam of the ear to see if a patient has an infection or perhaps it may be Eustachian tube dysfunction with “my ear hurts, give me antibiotics?”
Yes, telemedicine and remote medicine needs a place but should not be the norm. Many things can only be seen on examination and you cannot hug a patient or give a little child a high-five over the wires of communication.
McMedicine will be overly concerned about numbers. As stated, P4P targets numbers, such as LDL cholesterols, HbA1C’s, etc. Yes, these numbers are important and these goals are valid.
However, if the patient still does not eat healthy or get off the couch, they still face many health risks. Increasing activity more often has been shown to prolong life. Can we put a number on this? Either way, it would be better to have a face-to-face encounter with a real doctor to explore these lifestyle issues.
Our world becomes exponentially more fast paced all the time. Everywhere there are drive thru lanes and speed check outs.
But, medicine should be different. Doctors should be allotted time to know their patients and not be forced to generate a certain amount of cash. Patients are human and should not be checked out like a cart of produce and cheerios. They are much more valuable. Their humanity must be restored to them. They are not just a target LDL goal or a good clinical heart attack outcome.
Sometimes, a listening ear is the best medicine in the world. McMedicine may come, but like many things that become franchised, it will not be any better.
And like eating too many Big Macs, it may decrease the health of many lives.
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