November 6th, 2017
Podcast 215: Has primary care been Amazon-ized?
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Timothy Hoff thinks clinicians “must finally recognize that they are indeed ‘workers’ whose ability to control their daily fates has been reduced greatly.” He worries about the continuing erosion of the doctor-patient relationship, and he wonders why the profession is so reluctant to view its members as “put-upon workers struggling to gain favorable conditions for their work within corporatized health care settings.”
We talked with Prof. Hoff about his just-published book: “Next in Line: Lowered expectations in the age of retail- and value-based health.”
To the barricades!
Agree with Dr Hoff interpretation of what is occurring in medicine today. Burn out of physicians is the result of the lack of satisfaction that many physicians have because of the way they have to practice to survive. It is the result of the commercialization of medicine and the threat to the physician/patient relationship.
Thank you Professor Hoff for continuing shine a critical light on what passes for health care in this country and the effects of corporate take-over on the ability for patients and physicians to maintain that sacred relationship that we all (try to) hold so dear. While everyone knows the current system is broken, few offer actual, real-world strategies on how to fix this and take back medicine. Fortunately, I along with my dedicated Direct Primary Care colleagues are doing just that. DPC is a grassroots efforts led by passionate, dedicated, sometimes LOUD primary care physicians who are re-establishing the doctor-patient relationship one day at a time. These doctors gave up financial comforts of employed practice in the “2.0” system and instead have forged ahead to define Healthcare 3.0 where the focus is on patients, not paperwork or meaningless metrics. Where clinic notes actually say something and patients have as much time as they need with their doctor to help provide ACTUAL CARE. Where in-house procedures are FREE and medications and labs are provided AT COST without a dozen middle men making a cut. It’s the way primary care is meant to be practiced and it feels so good to be doing the right thing.
I do agree with the author wholeheartedly. Having said that, however, I think expectations on the part of both clinicians and patients will change over time. Where once we thought nothing of an MD with a black bag making a house call and the patient writing a check; those days are long gone, forgotten and not part of society’s cultural norm. If we do get to the “Amazon” form of care there will be resistance, resentment, and lots of negative publicity — and even Congressional hearings. But let’s be real, with time, younger clinicians will expect it (not the same as liking it), and patients will accept it (and not necessarily like it). And it will be the social norm.
Hospitals, administrators, and insurances want to disempower the physician and devalue the relationship with the patient because the physician is the only piece which generates the revenue, who they cannot fully control. We cannot let this happen
Yes patients want access, to THEIR doctor, not ANY doctor