Few people can argue that health care is a business these days. Medical services are attached a price tag and patients are now customers. However, intrinsic to health care is a very high ethical code that doesn’t exist in other sectors. For example, if a patient shows up in the ER, they cannot be denied service, whether they are wearing shoes or not. While McDonald’s and other top companies are driven for profits, there are lessons the health care industry should avoid taking from them.
What practices should be avoided in medicine?
High volume earns more money no matter what industry you are in. However, numbers of treated patients should never be driven up just to increase revenue. Patients need a certain amount of time in order for doctors to reach accurate diagnoses and treatment plans. A doctor-patient relationship cannot be forged on a medical assembly line, and without that relationship, there is no trust. Mistakes happen when the flow is too fast. However, in medicine, that can result in a patient’s death and not being stuck with a cheeseburger instead of the McChicken sandwich you ordered.
Supersizing it may be a good thing if you like french fries, but more medications can be harmful. Our society has fallen into the mindset that many things can be fixed with a little pill. If you can’t sleep, there is a medication for that. If you need to lose weight, there are medications and even surgery for that. But, the best fix for many problems is often the least complicated of all: a healthy lifestyle. Relying on more pills increases the chance of medication interactions that can be deadly. No drug comes without side effects. Patients often do need multiple medications, but we should try to use the least possible to treat the patient.
The customer is not always right in health care. As physicians, we need to include patients’ wants in any treatment decision. However, we possess the higher degree of medical knowledge and sometimes we need to steer them away from decisions that may harm them. For example, if a patient requests a medication that is contraindicated in their diagnosis or with other medications they take, we have to tell them no. As doctors, we must avoid doing any harm. If you go to the fast food counter and you want to eat ten cheeseburgers, they are going to give you ten cheeseburgers. If it will make you happy to have the tomatoes removed from all of them, they will do it. They want to make you happy. In contrast, your doctor wants to keep you alive and healthy. Hopefully, we can make you happy as well. But that is secondary to your health.
While the drive-thru may be convenient when you want to pick up a combo, it doesn’t work in health care. Patients bring many issues when they come to the doctor, and we can’t just push them in and out.
Coupons may attract you to one fast food joint over the next but is that something you should use in choosing a doctor? Doctors are using advertising more and more these days with some even offering free consultations and coupons. While I see nothing wrong with doing this, I don’t think this is the only reason you should choose a specific doctor. The best way to know is to ask people. Word of mouth is the best advertising. If people say he/she is good, I would trust that more than a buy one get one free deal.
While health care evolves further into being a business, we all need to evolve with it. However, we must make sure that basic standards and ethics are not lost. Doctors took an oath to do no harm, and that must be the first tenant of any health care business model. The patient must always be the center of the plan, and all goals should include optimal clinical outcomes. Patients need a voice in the new world business medical economy, and they should not be pushed aside for profits. The purpose of medicine is, always has been and always should be for saving lives and helping patients live healthy. Anything short of that aim is simply unethical.
Linda Girgis is a family physician who blogs at Dr. Linda.
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