The amount of waste in our medical system is frightening. Pretty soon, most of this economy will be based on insanely expensive medical care which will render us totally uncompetitive with the rest of the world. Those of us who actually provide medical care deserve to make a living commensurate with our training and capability just as patients deserve to receive care equal to what they pay for. Neither doctor nor patient should have to account for redundancy. Do we really want to pay for hundreds of thousands of bureaucrats sitting around, thinking up ways to make our lives miserable?
Doctors are at fault more than anyone else. We did not govern ourselves and we are the only ones who can do this effectively. There are unfortunately way too many bad and/or unethical doctors providing poor and overly-expensive care. Where is the respect we had in the past? Most of us still deserve that respect, but we allowed those that should have been sanctioned to give us all a bad reputation. The result is that we now have an army of bureaucrats without a medical education coming up with utterly stupid ways to control doctors and their patients. Take the “Pay for Performance” debacle. Those of us primary care physicians who are well trained and care about our patients have been performing by these “new” rules all along! Because of poor training and neglectful practice, we now have yet another army of bureaucrats policing us and telling us what we have to do to get paid instead of actually solving the problem. Those in power think they can somehow threaten poorly trained providers into practicing medicine correctly by spending billions on bureaucracy instead of spending the money on training more of us correctly and making primary care a more enjoyable specialty for those interested in a medical career, thereby resulting in intrinsically better medical care. Doctors have to set up systems which allow us to monitor and strengthen our own network without threat of lawsuit.
Even the best doctors are being threatened by an irresponsible and frightening legal system. Just look at all the legal ads on TV (we call this “ambulance chasing”). They make me sick to my stomach. Let's take a drug like Xarelto. Xarelto is one of the new anticoagulant drugs we use to protect people from blood clots and strokes. It is significantly safer than the old drug we use to use called Coumadin or Warfarin. But, it is an anticoagulant and you will bleed more as a result of injury or certain other medical maladies. We use a drug like Xarelto because we know from studies that the risk of dying from a stroke or blood clot is higher than the risk of somehow bleeding to death. We are going in the direction of lowest risk, but the legal ad people refuse to understand this. So Dad is on Xarelto for Atrial Fibrillation and gets into a car accident which causes an injury within his brain and the ensuing hemorrhage kills him. His daughter sees the TV ad and is led to believe she can make a lot of money on this and she calls the telephone number displayed. What happens next is the lawyers threaten the manufacturer, who instead of fighting an expensive battle in court (which they would win) find it cheaper to settle the case for $20,000 of which the lawyers get half for doing almost nothing except running an ad on local television. What happened to Dad is not negligence or malpractice - his doctor was absolutely right in prescribing this drug and he and the pharmaceutical company are being punished for making a better drug. These “ambulance chasers” are preying on people's bad luck. They prey on the bad luck that killed Dad. They prey on Doctors' bad luck by scaring us into doing a lot of unnecessary and expensive stuff. Doctors get taken extreme advantage of at everyone's expense. They are (hopefully) trained to work compassionately with people whereas businessmen and lawyers are adversarial by nature.
We will never fix this medical system without legal reform. My own current solution to the problem is simple: each medical malpractice case has to be reviewed by an unbiased and expert panel. If the case is denounced by the panel, you will still be able to take the case to court. If you loose, you must pay all legal and court expenses for BOTH sides. Rock and Roll!