Friday, December 30, 2011

Health care as medicine not a business

Here's a concept - let's have health care focus on medicine and curing patients and not as a business focused on the bottom line. Before you jump up and down and say that health care is a business because there are fees and payments and people to pay and services to hire, blah, blah, blah. Yes that is true but my point (and I always have to have a point) is that it should not focus on the business side but on the patient side.

A hospital or medical center or a single doctor's office has to run as a business but it really should put the priorities of the patients first. Did the doctor become a doctor to be rich and drive a Mercedes or did the doctor want to cure people? I think that people choose their careers with an eye to doing something that gives them some satisfaction as well as pay the bills. I mean if you want to get rich and drive a Mercedes there are ways to do that without cutting sections out of people and peering inside their bodies. You can become a stock broker or something else.

Hospitals are medical centers are designed to be places where patients receive care and they should be run that way. What is in the best interest of the patient and their care? If a doctor needs another test to figure out what is wrong with a patient, why can't they order it? Why does it have to be approved by an insurance company? If a doctor wants to prescribe a drug for a patient, why can't they choose the drug they believe is the right one? Not the one that the pharmaceutical company is promoting this week?

All of this is true for others in the medical profession - technicians, nurses, interns, therapists, etc. Medicine is about the patient, not about the bottom line.

If we reread the Hippocratic Oath, which is taken by doctors and other medical professionals, I do not see any reference to insurance companies, manufacturers, red tape, hospital administrators, pre-approvals, etc.

I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not", nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

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