This week in the Wall Street Journal there is an interesting ‘on the ground’ look at health care and how it has changed in the past 50 years. The article is particularly worth watching because it is written by ‘former’ physician Dr. Ed Marsh.
Dr. Marsh opened his practice in pediatrics in the early 1960’s, ran a solo practice for many years until he joined a third party group, feeling the growing interaction with insurance and government regulations.
“Preventive care” became the touchstone. The concept is obvious, but the evidence for its value, and especially its potential for savings, is rarely conclusive.
Insurance relationships drove practice relationships. Patients were more likely to come to me because their insurance told them to, and more likely to leave, despite our congeniality, because their insurance required it. Thus our dealings were less personally rewarding, for my patients and for me.
When it became increasingly difficult to work according to my principles, I closed my practice, first joining a “prepaid” group for 15 years, and then leaving patient care altogether. As more physicians leave active practice, it must be appreciated that a focus on the economics of health care is not the only, and perhaps not even the most important, reason for their disillusionment. The glow of the personal relationship one might have with one’s patients is being extinguished.
You can read the full article at the Wall Street Journal. For additional information on the changes in health care the editorial board of the WSJ gives a helpful, yet brief, synopsis explaining our managed care past and where we are today. Board member and Pulitzer Prize winner Joe Rago explains why the big bureaucracy of Obamacare will decrease the relationship between you and your doctor while making it more difficult to get the care you need.