This week on the blog I wanted to talk about how medicine has changed over the years. How its changed for a doctor, a patient, and how those relate to each other.

Specifically, how it’s changed over the course of two physician’s careers.

I had the opportunity to sit down and talk to my good friend Dr. Paul Gorman (You can check out the interview at Performance Medicine Audio), a well known hand surgeon in the Tri Cities, and discuss some of the changes and how it’s affected doctors and patients.

When I asked him how medicine has changed over the course of his 30 year career as a physician, he emphasized two things:

  • The distraction of both doctors and patients
  • The influence of third party payers

The distraction of doctors and patients

Doctors have become busier and busier with paperwork, record keeping, and office policies.

All of this has become a major distraction to patient care. The doctor’s time should be spent with the patient, not jumping through hoops after a visit in order to get reimbursed by someone other than that patient.

Nowadays, there is less focus on listening to the patient and getting to the root cause of why they are there in the first place.

Patients are also distracted. We’ve created a system where we want to indemnify routine things. We believe wellness visits and basic quick care should be taken care of by prepaid healthcare dollars.

So the patient is looking for things to be taken care of for them, which often means seeking coverage more than seeking to get healthy.

The influence of third party payers 

Dr. Gorman mentioned in the interview that one of the big mistakes we’ve made as physicians is that we’ve let other people tell us how to practice medicine.

Health systems, the government, and even third party payers all have power within the system to dictate patient care.

One thing I’ve learned over the years is that insurance companies don’t want to pay doctors and their clinics. So what do they do? They end up creating a whole bunch of extraneous work for doctors and their staff to fulfill in order to get paid.

This system has lead to doctor dissatisfaction, which of course leads to less quality of care.

Where do we go from here? 

Medicine has changed quite a bit since Dr. Gorman and I started practicing over 30 years ago. In addition to some of the negative changes, there’s also so much good happening in medicine with all the advancements and the technology.

There’s two shifts I’d like to see us go in.

In my opinion, we need to continue to redefine what health insurance is and what it’s for. We need to go back to what it used to be: High Deductible, Major Medical, Catastrophic Insurance.

This is a mindset change, nothing more.

The next thing we need to do is get back to transparent pricing. Offer a good service/product at a fair price.

The last thing I’ll add in this note is we as physicians need to work hard to establish that doctor/patient relationship. This should be the main focus of doctors and providers.

It’s not only good for the patient. It’s extremely healthy for the doctors and the providers.