Free enterprise in medicine fails because of physicians,
lawyers, insurance companies, and patient greed. My doctor’s appointment this
morning confirmed for me that free enterprise in medicine does not work. In
banking, they have a word for fraudulent use of checks, bill or receipts and
other financial instruments we have learned to trust, but in the medical
profession, no equivalent word applies to physicians who use their medical degree
we have learned to respect to defraud their patients. When a physician says you
need this or that test, or another opinion, you accept that statement at face
value without questioning why. I am convinced they have used this trust to
defraud you as a patient
My wife, my daughter, and I have all been in the hospital at
one time or the other. In each case, we all questioned certain things but
especially referrals to other physicians or specialists. A strange lexicon of
names invariably appears on our hospital bills for a month after the fact
without us having any idea of who they are or what they did. Anesthesiology,
pathology, and radiology are examples of labels put next to these names if they
even bother to attach a label to the names. These strange names draw two types
of response; trust the doctors, the names wouldn’t be there if they didn’t do
something and why do you care, the insurance will pay. Who pays the outlandish
monthly premium and the insurance company stockholders?
The truth is because people are sue crazy; we live in a
litigations society. This fact has come to haunt us. Physicians are easy
targets for “free money”. The nature of medicine is that there is always a
chance they will find something “more” serious no matter how low the probability
of that happening, if “they” do one more test, one more x-ray, or have one more
opinion. The other problem that feeds into this is that physicians are so
narrowly trained that they do not have confidence to diagnose anything but the
common cold. Add to this the willful limitation put on training modern
physicians have put in place in specialty areas. There is an inverse aspect to
this. More and more Orthopedic surgeons look only at knees while others only
look at ankles, or hips, etc. Magically, those who look at knees do not have to
waste good golf time studying the latest techniques that have to do with
ankles. Imagine where this places a general practitioner on the scale of
learning but more importantly in a court of law when faced by an aggressive lawyer.
I have had four visits to the general practitioner; three of
the visits resulted in his referring me to specialists, and one was to draw a
blood sample, which they sent to a “commercial” laboratory. When the results
come back for the two or three hundred dollars worth of laboratory tests, I was
sat down while the physician compared the results to a chart of normal values
supplied by the laboratory and told everything was normal range. My cost was
the time wasted and $40 co-pay compared to the cost to the insurance company
was over $800. As I left the clinic this morning the nurses were calling after
me as I went out the front door of the clinic, “ Don’t you want to a make an
appoint for a return visit in two months?”
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