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Fixin' Healthcare

Friday, February 24, 2006

The Lifestyle Chronicles - Life Is Short; Art Is Long

During my early years in medicine it never occured to me that health care was a commercial activity. I doubt my classmates or fellow house officers ever gave much thought to the commercial aspects of medicine. Please don't misinterpret that our thoughts and motives were so pure as to exclude money. Believe it or not, medicine had not yet been commercialized.

In those days there was frequent reference to medicine as an art and a science. This is not a reference you hear often today. I would hazard the observation that today medicine is more of a science and a business. You could also say that relative to today medicine then was more art than science.

These observations might appear judgemental and perhaps I am guilty. Memories are like difficult girlfriends. The further you get away from them, the more romantic they become. No, my purpose is more pragmatic. It is a good time to ask what has been gained and what has been lost. If health care is to be reformed, let it be based upon more than economic principles.

The essence of medical care is the encounter between a patient and a provider. Over the past 50 years this encounter has become surrounded by numerous enterprises and the nature of the encounter has been radically changed. Evaluate that encounter to determine value and quality.

Just so you will know where I am coming from; my spirits are dashed upon the rocks by pharmaceutical advertising, the multiple understandings and misunderstandings of health insurance, imperialistic hospitals, the wasteful aspects of competition, the worship of technology, the lack of emphasis on prevention and the forced march of primary care on the "trail of tears".

(Once upon a time - and they lived happily ever after.)

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