There is so much to weigh in on. I’ve watched many independent doctors become the “owned” employed doctors in my 30 year career. And I can speak to that personally. The administratively heavy behemoth hospital organizations incentivize and demand the treatments, because, after all, it is “standard of care.” You no longer could exercise good clinical judgement, let’s say, and evaluate Johnny’s bop on the head with a soccer ball and end it there. It MUST have a Ct scan to rule out a bleed, when you know there are no clinical signs of this. Much of the practicality of medical judgement has been replaced with “standard of technology” and with that technology (radiology, robots in surgery, a-lab-test-for-everything, nanotechnology) comes a high price tag.
For God’s sake, the electronic health record requires its high cost of implementation, management, and cybersecurity. There are many “hidden” costs of doing healthcare business, that add up quickly. So what do we do? We have to pay for this tech somehow, so we incentivize screening tests for prevention or recommend surgeries to use our cool robotic machines.
And to your one point…. Imagine being a physician in a room full of lawyers explaining why you did not use a particular expensive test because it wasn’t warranted….
This is complicated. No doubt. You have done an intricate deep dive. The problems are complicated and the solutions are equally complicated.
Your point about how the American lifestyle is unhealthy is well-taken. I lived in Europe for three years. I’m convinced that Americans would be healthier with simple changes such as walking more and eating healthier food in smaller quantities. Even with desserts we could change things. Desserts in Europe are quite tasty. But they generally aren’t as sweet as American desserts. Europeans are also better about taking time off from work. Europeans aren’t perfect. For example, they took a long time to move away from smoking. Still, if an ounce of prevention is worth a pound of cure, we could learn a few things from them.
What's amazing is despite having TASTIER food, they eat smaller portions of it. I would have expected a positive correlation b/w yumminess and amount consumed.
There is so much to weigh in on. I’ve watched many independent doctors become the “owned” employed doctors in my 30 year career. And I can speak to that personally. The administratively heavy behemoth hospital organizations incentivize and demand the treatments, because, after all, it is “standard of care.” You no longer could exercise good clinical judgement, let’s say, and evaluate Johnny’s bop on the head with a soccer ball and end it there. It MUST have a Ct scan to rule out a bleed, when you know there are no clinical signs of this. Much of the practicality of medical judgement has been replaced with “standard of technology” and with that technology (radiology, robots in surgery, a-lab-test-for-everything, nanotechnology) comes a high price tag.
For God’s sake, the electronic health record requires its high cost of implementation, management, and cybersecurity. There are many “hidden” costs of doing healthcare business, that add up quickly. So what do we do? We have to pay for this tech somehow, so we incentivize screening tests for prevention or recommend surgeries to use our cool robotic machines.
And to your one point…. Imagine being a physician in a room full of lawyers explaining why you did not use a particular expensive test because it wasn’t warranted….
This is complicated. No doubt. You have done an intricate deep dive. The problems are complicated and the solutions are equally complicated.
Brilliant. I laughed. I sighed. You have accomplished your limited mission splendidly.
Your point about how the American lifestyle is unhealthy is well-taken. I lived in Europe for three years. I’m convinced that Americans would be healthier with simple changes such as walking more and eating healthier food in smaller quantities. Even with desserts we could change things. Desserts in Europe are quite tasty. But they generally aren’t as sweet as American desserts. Europeans are also better about taking time off from work. Europeans aren’t perfect. For example, they took a long time to move away from smoking. Still, if an ounce of prevention is worth a pound of cure, we could learn a few things from them.
What's amazing is despite having TASTIER food, they eat smaller portions of it. I would have expected a positive correlation b/w yumminess and amount consumed.