Magazines scare us with doctor shortages. Cutbacks in Medicare are loudly touted everywhere. Medical errors make front page news. Is there anyone who does not know about the heparin overdose given to the newborn twins of actor Dennis Quaid? After describing each medical event in minute detail, writer moves directly to a proposed solution: more money, more regulations, or more penalties. No one discusses WHY.
To cure anything –a bad golf swing, a budget over-run at work, an individual patient, or our entire healthcare system – requires knowledge of the cause. Effective therapy is always aimed at the why, not the what. You treat the reason for someone’s headache – you do not simply give morphine.
We do not have to guess. We know why: there is a shortage of doctors; Medicare is running out of money; and there are frequent drug errors and complications.
There are shortages of doctors and nurse because professional dissatisfaction is driving people away. If we want to cure shortages of health care providers, we must treat professional dissatisfaction.
Medicare seems to constantly run out of money because the system counts only one thing: short-term costs. The why is measurement problem: too short a time frame and no positive outcomes. If you want the money to be there for you, we have to start rewarding long-term value – a net positive lifetime cost/benefit ratio.
Medication complications are easy to understand and even easier to cure. Computer experts say it is child’s play to design a national drug dispensing program that would prevent a person from getting the wrong drug; or the right drug at the wrong dosage; too many drugs; or drugs that have a bad interactions. All we need is the will and enabling, rather than constraining, laws.
Shall we resolve this New Year to treat causes, not symptoms?
The System MD
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