Health care's the ticket, Craig Barrett says

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Technology and Separating Good Medicine from Dollars

Good Points - But that the AMA not saying "no" is not as simple as just whether they are working hand in glove with insurance companies - I think it's not quite as collaborative as that! And like you, I can't just tell the insurance companies to kiss off, my whole staff would be out of work and I'd be out of business. Now if EVERY patient and EVERY doctor did that - well....

Staying on the technology thing. Separation of "good medicine" from making more dollars is not as simple as just tracking claims data. If huge resources are expended to track, say, HgBA1C results amongst diabetics, or beta blocker use in post MI patients, this is a good thing and, perhaps, worth some of those resources. I qualify that with "perhaps" because responsible patients and good physicians ought to be able to accomplish that without the enforced assistance of enormously expensive 3rd and 4th party technology and insurance companies. Patients who assume responsibilty for their own health care and physicians who facilitate it, are paying for that technology and administrative burden anyway - with higher insurance premiums and lower re-imbursement and, more to the topic of this thread, less confidentiality.

It was of course technology and it's abuse that made HIPPA necessary (although patients gave up more confidentiality than they gained by this federal law). When we turn over responsibility for anything to someone else - health care, education, we also give up our automony.
But back to good medicine vs dollars.

My own health care premiums have doubled in five years (as I'm sure yours has too..), but reimbursement for my services (from this same company) has remained flat. Where does the money go? - according to a representative at that company - the pharmaceutical industry - but what he didn't say but I suspect - it is also all those new office buildings, legions of claim administrators and of course, the technology to track every single encounter every single person has with every single health care provider.

So when I had to cut overhead - letting my Physician's Assistant go and increase the hours I have appointments and increase the density of those appointments to make up for the enormous increased cost to provide that care (the insurance companies all tell me that I have to see more patients if I am to make up for increased overhead) - and still make less than I did 5 years ago - I'm not complaining - I'm stating fact - Are we REALLY improving health care - wouldn't you rather have more time to talk with your doctor (your insurance company has no interest in paying for THAT - their technology is just interested in whether a HgBA1C shows up in their claims data)? Is having the time to talk with your physician as important as whether or not the insurance company knows you are there and the QC disease management guidelines are met?

Over a hundred years ago a famous physician, scholar and teacher at Johns Hopkins - William Osler (I think that's the name) - said that if you listen closely - the patient will tell you the diagnosis 90% of the time.

Well -I still try and listen - but I keep getting interrupted - This insurance company has this formulary - that insurance company needs a precert (which by the way is using a whole other technology company to administer that!) and the hospital is on the line to say that my patient's insurance has changed and now they need a second referral! All the while the patient in front of me is anxious, not about telling me his history, but whether HIS new insurance company will cover the specialist or or that the lab might reject his claim.

Good Medicine is not the automatic result of more money or more information technology. IMHO - Technology does *not* automatically improve health care but it does automatically increase it's cost, despite claims to contrary.

Hey - thanx for the discussion, I gotta go to work!

Posted by: MWPowell57   Posted on: 04/14/05 You are currently: a Guest | Members login | Terms of Use

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