Doctors, Horse Traders, and Used Car Salesmen

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The profession of medicine — and the delivery of health care in this country — should be free of the same kind of chicanery used to move goods on the open market.
The profession of medicine — and the delivery of health care in this country — should be free of the same kind of chicanery used to move goods on the open market.

Medicine used to be an honorable profession. Used to be. But now, medicine occupies the same rank as horse traders and used car salesmen.

And I say this, with all due respect to people who earn a respectable living selling horses or automobiles.

Consider this: for the business of medicine to work today, someone has to sell something to someone else. It starts at the top; insurers or payers must sell contracts to hospitals or providers. These hospitals and providers agree to accept “X” number of dollars in return for services rendered.

Patients, too, must be sold on whatever it is that will attract them to a medical clinic or hospital in the first place — reputation, cost, location, or wait time.

Doctors must also be sold on the establishment for which they work. They must earn enough — in terms of salary and benefits — have the staff support they need, the right location, and so forth.

Everyone has to be sold on something.

But shouldn't the time-honored profession of medicine be divorced from such horse trading and persuasion?

Should profit even be a consideration in patient care? Should anyone have to sell anything to anyone in order to do what's right for the patient?

Shouldn't doing what's right be a given, regardless of where the chips — and dollars — may fall?

For many readers, these questions will seem strikingly naïve. But, they get at some fundamental items that our society has plainly failed to come to terms with yet.

Unfortunately, the healthcare delivery system in our country has become politicized. This makes it even more prone to influence – much like that of horse traders and used car salesmen, except on a much grander scale.

Politics is all about constituencies, great numbers of people, and huge demographic influences. The more people  involved, the higher the stakes and the greater the chances of shady backroom deals and corruption.

So human are we; so gullible, so easily manipulated, and so easily sold down the river. Which is precisely why the profession of medicine — and the delivery of health care in this country — should be free of the same kind of chicanery used to move goods on the open market.

And it needs to start not at the top with the pundits, politicians, and payers, but with individual doctors working in the communities they know and can best serve.

It needs to start with us, brothers and sisters.

After all, where and from whom we get our health care is a deeply personal and ultimately very important (sometimes critically important) decision for any patient. And doctors like us shouldn't be tainted or contaminated by less-than-savory horse trading influences anywhere in the sphere or chain of command.

And much less so in our individual practices.

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