Pass the Health, Hold the Doctor

It is a common assumption that health status depends upon the availability of doctors and hospitals. I can understand that doctors and hospitals want people to believe health status depends upon their services. Also, medical schools would be in favor of producing more doctors, as well as the hospitals and communities that want to start medical schools. Let us not forget that medicine is an industry but it is an industry oriented to sickness. Is sickness, even sickness well treated, the best pathway to better health status? Perhaps it might be better to plan on less sickness.

A recent study of Texas Medicare claims data revealed a disparity in colonoscopy screening between white, black and Hispanic populations with whites receiving more screenings. In those communities with more doctors, the disparity was even greater in favor of white patients. Placing aside the question as to whether the number of colonoscopies is necessary regardless of race and ethnicity, this is one of many studies showing that more doctors frequently do not yield the desired result. That is to say the result desired by patients and the community.

Meanwhile, the data continues to accumulate that better health status depends on much more than doctors and hospitals. Some communities have come to realize improving health depends upon things involving life in the community. Kansas City, Kansas is an example but there are a growing number of other communities seeking more health for the care and sense there is a more effective way.