Look to China for the future of American health care

Chinese hospitals are recruiting 1,500 “guardian angels” to protect doctors from violent patient attacks. Patients who are angry about the Chinese health care system, medical expenses, long waiting times, and uncaring doctors have become more violent over the years, with violent attacks occurring every two weeks on average — according to state media — which in reality means that it probably occurs a lot more frequently than twice a month.

Now China is starting a campaign to get volunteer students, medical staff and other patients to intervene when patients are upset with physicians. Apparently China views non-physicians as being more expendable when patients become upset and brandish cutlery. At least we have concealed carry laws in the US … for now.

Interesting that according to the article, China has created a culture in which “doctors are in crisis” and in which “medical practice in China is a high-risk job.” Now China is vowing to “root out corruption in the health care system” — to save all the patients from the evil and corrupt medical providers.

In reality, China’s policies have created many of the problems it seeks to “root out”, but state-run media likely won’t put that in print, either.

After reading through the article, think about what it happening in the US right now.

Doctor rating sites and patient satisfaction take precedence over proper medical care.

Patients are forced to purchase government-mandated “insurance” that in many cases doesn’t pay for the cost of care and that many doctors will therefore not accept as payment. Losing money every time that you provide medical care to patients — while paying off student loans, paying office overhead and salaries, paying malpractice insurance premiums, and paying licensure fees — is just not a sustainable business plan. As a result, patients pay a lot of money for government insurance but they often have difficulty finding medical care when they need it.

Federal agencies, in order to improve “transparency,” publish a list of how much money the federal government is paying physicians so that it can make physicians look like overpaid whiners when they complain about their workload and the regulatory burdens of a medical practice.  But the same federal agencies refuse to publish statistics about patients who abuse the system (“privacy rights” apparently outweigh the public’s right to know about illegal acts) and the same government hides data about maltreatment of patients in its own facilities. Transparency indeed.

Regulations related to the provision of medical care rise exponentially and educational costs to become a physician steadily increase while payments for medical services steadily decline.

The pervasive media message is what a lousy job physicians are doing. Increased malpractice. Unnecessary testing. Missed diagnoses. Malpractice verdict after malpractice verdict. Hundreds of thousands of deaths each year from hospital errors.
A well-respected profession is now becoming despised.

By systematically making the practice of medicine more difficult and less appealing, the United States is slowly creating a crisis similar to that which China is experiencing now. The more insidious problem is that it takes at least 10 years and sometimes up to 14 years to educate and train a new physician. Cause the best and brightest students to shy away from medicine while older physicians retire or die off and in 5-10 years there will be an even larger crisis that will be impossible to immediately solve.

At that point, it may no longer be an issue of which doctor you will choose to treat your medical problems, but instead a question of which doctor will choose to accept you as a patient.

Then who will the government and President Obama blame?

And will the proposed cure be worse than the disease?

Look to China.

Then look to Venezuela.

Boy am I glad I’m a doctor.

WhiteCoat is an emergency physician who blogs at WhiteCoat’s Call Room at Emergency Physicians Monthly and Dr. Whitecoat.

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  • Dr. Drake Ramoray

    “At least we have concealed carry laws in the US … for now.”

    It is illegal in every state that I am aware of (even Georgia with it’s most recent legislation) to concealed carry in a medical facility.

    • NewMexicoRam

      In New Mexico, the owners of any property may post signage stipulating “no concealed weapons” and the gun owner must obey, or it’s a 4th degree felony. But it’s legal to carry a non-concealed weapon anywhere, as long as the gun owner has a legal permit.

      I would imagine that federal laws prevail in VA hospitals.

      • NormRx

        My VA clinic has a big sign stating “No Weapons Allowed.” I always kid them when I go there telling them that it a good idea since we can’t trust our veterans with guns. Virtually all of the employees think the no guns allowed sign is stupid.

        • Dr. Drake Ramoray

          This country has moved to a place where are soldiers can’t have guns on their person on base so I’m not terribly surprised they can’t at the VA

          • NormRx

            Of course not. According to our own government, veterans, pro-life, NRA members and Tea party members are all potential terrorist that should be watched.

  • LeoHolmMD

    China is too far away to look. The VA is much closer, and we can see how our nations heroes are treated like third world dogs right here in the USA. Right, Phoenix? It was a physician who exposed that. We need to let our patients know who are really on their side.

  • SteveCaley

    I’d heard that New Mexico still has the laws from the Wild West, though – OPEN holster carry is legal on the streets, I’m told. I expect that the holster has to be outside the white coat, though.

  • Judgeforyourself37

    Here in the US hospitals are refusing to hire sufficient numbers of RNs, are buying up many physicians’ practices, They are nothing more that greedy corporations with far too many in “management” who are receiving obscenely high salaries and benefits. In many instances those RNs, whom they do hire, are only hired on a per diem basis.The “do more with less,” mentality, which is so prevalent in hospitals, will continue to see patient dissatisfaction, and some very angry patients. The computer systems in many hospitals are not coordinated, and a different nurse, or secretary will come in with a computer on wheels up to five or six times and ask the, all ready anxious patient or family member the same multitude of questions regarding name,address, age and medications. Sometimes patients will take out their wrath on both physicians and nurses.
    Patients who are “self pay,” will pay at a higher rate than those with Medicare, Medicaid or other insurance plans. These plans will only pay a set amount and the hospital, if they agreed to accept these plans, must take whatever amount is paid. The self pay patient does not have that privilege, they pay the full, inflated, amount ($90 for Tylenol, etc.). Self pay patients or if the patient has died, their family members, sometimes can “negotiate” a lower rate, but often that is not always feasible.
    We do not need to “look to China” but perhaps we should look to other nations, such as Canada, Germany and the UK, as they have single payer systems. They have better patient satisfaction, yes, they do as I have friends in these nations. They, also, have better working conditions for both nurses and physicians.
    Health care is NOT a privilege, it is a RIGHT, and we must take the greed out of the US health care, and that includes insurance company greed, too.

  • Judgeforyourself37

    First, before you criticize “Anecdotal” evidence, learn to spell simple words, such as “ambulance,” and “doctors.” HIPPA can be a pain, but it keeps a patient’s medical information confidential. Keeping patient information confidential, was and is the paramount in gaining patient trust. This was taught to me in what you may call the “dark ages of medicine,” in the 1950s.
    As for emergency care, that varies from hospital to hospital and IS very expensive, and should be only used in an emergency. With the ACA, in the states that expand Medicaid, preventive care can eliminate using the emergency departments of hospitals from being a person’s “primary care source.”
    Perhaps some of your “friends” were dissatisfied with care in Canada, England and Germany, but mine were pleased. Yes, non emergent care or elective procedures entailed a wait. However, emergent care is immediate, and excellent.

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