Improving Patient Care by Focusing the Doctor’s Attention on Them

There is a crisis in America’s healthcare system and one of the symptoms of this crisis is inappropriate treatment and care for patients. No doctor wants to have any obstruction between them and their patient – the vast majority of doctors work exceptionally hard to do the very best for their patients, however in a country where we spend more on healthcare than any other country in the world, we are struggling.

The RAND research institute found that a staggering 55% of Americans presenting a range of 30 conditions did not receive the appropriate medical treatment. This was in respect of conditions for which the treatment is known and the results well documented and supported by longstanding scientific evidence. There was a combination of misuse and underuse of medical treatment regimens by caregivers and doctors. On the other side of the spectrum, there was also substantial evidence to support the view that many patients also received too much treatment, or indeed treatment which would have no impact upon the conditions they presented.

This is not to suggest that doctors do not care about their patients. Far from it, however there is something going on beneath the veneer of the patient-doctor relationship.
Something which is distracting doctors from delivering the care they want to patients.

That “something” is the insurance company system.

Insurance companies have a stranglehold on the nation’s health. The current system involves premium contributions to insurers, subsidized in some respects by federal money and co-payments from patients receiving treatment. So far so good – patients do not have to find large sums of money to get medical attention when they are struck with illness or an accident.

Now we start to look at what happens when a patient presents themselves to a doctor.
They make an appointment, they go to the surgery, and the doctor examines them. The cost of the examination is met either by the patient or the insurer or both. In this case, a condition is diagnosed and at this point, the patient should or ought to be confident that the advice they will receive will be the unbridled truth about the treatment which is available and how effective it will be together with any life implications of receiving this treatment.

We are now firmly into the realm of the almost mystical, patient-doctor relationship.
Unfortunately, two is company and three is a crowd, because neither the patient nor the doctor gets the last word on treatment. It is the insurance company which must be consulted and who must approve the cost of the treatment being recommended by the doctor. More than this, in order to gain approval from the insurance company, a lengthy and bureaucratic approval process must be completed. This further eats into the time a doctor has to care for patients, leading to a loss of attention in the broadest sense to all of their patients.

This is exceptionally frustrating for medical practitioners, many of whom become jaded with the knowledge of insurance company practice. If a treatment regime is not going to be approved, what is the point of discussing it, or even recommending it the patient? This has led an increasing number of doctors to revisit the original medical practice model, where patients directly retained their physician and he delivered medical services to them in exchange. Under such a model there is no room for an insurance company to exert any influence upon the doctor-patient relationship, and all of the doctor’s attention is focused upon the patient at hand. Which is how it ought to be.

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