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The value doctors put on patient care compared to their own profit can be much more complicated than you may think. Although most people think that the only thing that should matter is the care of the patient, healthcare providers also have to worry about taking care of themselves and their own families. There are many different factors that go into allowing doctors to continue having a profitable business. These factors typically take a negative toll on patient care. This paper will expand on these factors and try to offer solutions that will offer excellent patient care while remaining profitable.
To start, it is important to define what good patient care actually is. There really is no straight answer to what it is, but to get a better idea, let’s see what two trusted sources define good healthcare as. The National Committee for Quality Assurance (NCQA) states that quality health care is “safe, effective, patient-centered, timely, efficient and equitable.” The Agency for Healthcare Research and Quality (AHRQ) defines quality health care as “doing the right thing for the right patient, at the right time, in the right way to achieve the best possible results.
” From the sound of both of these definitions, quality health care seems to be based more on intent than anything else. A provider can either intend on providing good care for their patients, making as much money as they can by doing the bare minimum and charging as much as possible, or they can intend to do both.
I think it’s fair to say that the majority of doctors attempt to do both, but is that possible?
In the American marketplace, capitalism is king. We are the only country who has capitalism in healthcare. The motto of capitalism is to try to make as much money as you possibly can for your good or service and the market will work out as a result. Dr. David Salter, a seasoned professional in the medical field, feels that capitalism has no place in the healthcare system. This is because healthcare is purely meant to serve people, and capitalism is solely meant to generate profit. When you mix the two together, it’s hard to find that happy medium of proper patient care and making the money they need to keep their business afloat. The urge to make money will always make healthcare expensive. Dr. Salter proposes a system more like the countries with the best healthcare in the world. Simply put, he believes that there should be universal healthcare for all patients. This will result in doctors making less money, but at least everyone will have access to the care they need. Dr. Salter did make some very good points, but there are some obvious implications that will come into place if this plan is ever enacted in our country. The cost of medical school will outweigh the benefits for many aspiring doctors and less and less people will want to be doctors as a result. As we can see in Canada, people have to wait so long to get surgeries that they end up just coming here to get them.
Before even becoming a Doctor, medical students are hit with an average of $200,000 in college debt after four years. This usually takes doctors tens of years to pay off. It’s easy to say, “we should just make medical school cheaper,” but they also have to make money just like healthcare providers. The guy that spoke to us in class enforced this fact with his own experience of having hundreds of thousands of student debt along with tons of other expenses.
Another factor healthcare providers have to deal with is malpractice insurance. Malpractice insurance is needed by healthcare providers to protect them from losing their entire practice after being sued. Tampa General Administrator, Cindy Williams, claims that patients are way to sue happy over every little thing. Her proposed solution to this problem is putting stricter laws in place that makes certain requirements that have to be met before people can sue. Cutting out that cost for doctors could allow them to put more of the time and money wasted on that into caring for the patient
Pressure from management on doctors to see as many patients as they can to maximize profit is yet another hindering element to adequate patient care. For example, doctors are now being graded by the amount of time they spend with a patient. This pressures doctors to get in and out as fast as they can to “care” for as many patients as possible to bring in more revenue. This type of practice is borderline unethical due to the obvious focus being on money, and possibly putting a patient in danger due to the pressure on the doctor. Practices like this are what is ruining that doctor and patient relationship. So what would be an effective way to measure doctor’s performance? Dr. Blight claims performance can’t be measured solely on the amount of time needed to treat a patient or even by a patient’s health. The one way he believes their performance should be measured is through determining whether or not they followed correct protocol for each situation. This protocol can come from an association of medical doctors. Cindy Williams’s experience in two healthcare jobs shows how much management can affect a healthcare team.
The lack of preventative care and abundance of reactive care is a prime example of patient vs. profit. Preventive care is the care you receive to prevent illnesses or diseases before they happen. Some examples include cholesterol and diabetes tests, cancer screenings, drug and alcohol counseling, and routine vaccinations. On the other hand reactive care involves treating a disease or illness after you find out you have it. This can be very costly and result in many debilitating symptoms. Some examples of reactive care include surgery and prescription medicine. It’s obvious that the reactive approach is favorable for doctors looking to get a big payday. The way Dr. Salter put it was that it is much more profitable for a doctor to perform open heart surgery rather than getting their patient to stop smoking through low cost preventative care. Dr. Salter believes that this approach is directly a result of capitalism. He claims that a universal healthcare system would encourage doctors to take a more preventative approach because it wouldn’t put a large dent in their profit like our current system would. Benjamin Franklin once said, “An ounce of prevention is worth a pound of cure.”
There are hundreds of things we can do to try to make healthcare more about the wellbeing of the patient and less about profit, but it has to start with one change at a time.
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