It's a model where doctors in corporate health care systems are just like factory workers who help provide their corporate bosses better returns on investment that are contiguous with raising the bottom line. Like some workers who are paid by how many widgets they create every hour, or how many bushels of fruit they pick, these health care workers increase their own productivity by seeing more patients every shift. To increase their own productivity, physicians become more "efficient," seeing patients every 10 minutes; maybe 30 to 40 a day. It's not unusual for physicians to have a 5,000 patient case load. Spend too much time with a patient, and you lose that productivity. Take time to research a patient's symptoms and consult with other physicians and you lose income. But, if you refer your patient to a specialist or order more tests, both you and the system will be happy with additional income. Get those patients into your exam room; move 'em in; move 'em out.
Physicians in some systems who take too much time with patients get reminders about being focused. They don't get reminders that spending more time with patients, sometimes just chatting about hobbies, the latest films, or the family, can help a physician better understand a patient's issues and problems. And since it's been decades since physicians made house calls--too inefficient--they don't see or understand how a patient's home or lifestyle might affect that patient's illness.
Most physicians, even those who take lessons from a Doctivity specialist, care about people. Most didn't go into medicine to be part of the country club set. But when corporations set up Doctivity-induced programs, even the best physicians reluctantly sacrifice the art and science of medicine, possibly forsaking the principles of the Hippocratic Oath, to the business of medicine.
[Walter Brasch is an award-winning journalist whose undergraduate degree was social work with a minor in health sciences. His current book is Fracking Pennsylvania, which has major sections about business decisions made by the oil and gas industry that may be more important to some companies than the health and environmental effects.]
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