Charles Smithdeal asked:




Times are not what they once were in the healthcare field. Doctors and hospitals are being pinched and squeezed–financially and otherwise. In the long run, patients are likely to suffer from many of the changes that are taking place.

Allow me to say up front that our U.S. medical system has serious problems. Costs have escalated to the point of being absurd. Such costs are unaffordable to many, and this situation cannot be acceptable to any responsible citizen. Too often however, doctors are mistakenly blamed for costs that are beyond their control. Most doctors work longer hours and earn far less today than they did a few years ago. So why are medical costs so high? And how do they affect a doctor’s ability to practice effectively? Let’s consider just a couple of areas.

Everyone wants improvements in a doctor’s ability to diagnose illnesses and administer effective treatments. Doctors and patients alike want to take advantage of the latest technological advances. But such advances are often outlandishly expensive. Consider the research and development costs of a new and unique electron microscope, Computerized Tomography scanner (CAT scan machine,) or Magnetic Response Imaging device (MRI.) These devices often sell for millions of dollars each. Proving that a device meets government specs and safety requirements often takes many years, and also adds to the costs. Once approved, manufacturing setups and specifications must be very exacting and expensive.

Here’s a thought: after such devices become available, does every hospital or diagnostic clinic in every town need one? Could they possibly be shared? Maybe one for every third hospital or every other town? Or made available 24 hours per day, 7 days per week?

Let’s consider the ramifications of this (slightly preposterous) cost-saving idea. Would patients tolerate long waits for test results–a likely consequence of such sharing? Or scheduling a non-emergency test appointment at 2:00 or 3:00 AM? Might medical-malpractice attorneys use “delayed diagnosis” as grounds for suing doctors or hospitals? And might uninformed lay juries award unrealistically large damages to victims of such delayed diagnoses?

It’s also very expensive for hospitals to meet all the government requirements for OSHA standards-Occupational Safety and Health Administration-a division of the U.S. Department of Labor. Administrative costs often skyrocket to oversee and police such requirements. Unlike a hotel, hospitals must operate and be fully staffed with professional healthcare workers 24/7. Someone may need an emergency X-ray, or blood test, or surgery. Supplies costs have escalated, but also salaries have risen dramatically for nurses, technicians, nurses’ aides, food prep staff, cleaning staff, etc.

A constant tug-of-war exists between medical-insurance companies vs. hospitals and healthcare providers. Remember, insurance companies are in the business of making money for their stockholders. That’s it. Their primary objective is NOT that of providing healthcare for subscribers. They would much prefer subscribers to simply mail in their premiums each month and never submit a claim. You’ll notice this if you ever apply for such insurance-read the fine print about what is excluded from your policy. To oversimplify somewhat, if you’ve ever been sick, are beyond a certain age, or have any bad habits, they don’t want you.

All right, these are a few considerations to explain why many doctors plan to retire early or abandon the practice of medicine altogether. In my experience, most doctors really enjoy helping people. They initially went into medicine and spent so many years studying and working long hours because they care about their fellow human beings. But today’s constant fighting with insurance companies in order just to pay their rent, outlandish medical-liability insurance premiums, employees’ salaries, etc, etc has taken the joy out of practicing for many doctors. Doctors today worry that that every other patient has a med-mal lawyer on “speed-dial” on their phone, in case the doctor doesn’t deliver an instant and satisfactory cure for whatever ails that patient. With government-sponsored healthcare looming on the horizon, a doctor’s lot is certain to become much worse. Can you imagine being in a serious accident, knowing that your local post-office staff now runs your hospital’s emergency room? Would you like congress to determine how much your local hospital spends for its supplies and equipment? Awarding the contract for your new heart valve to a family member, political crony, or “lowest bidder?”

Malpractice awards in our country have become ludicrous. Some are justified. Many are not. But the cost of defending “nuisance” suits-totally unfounded claims by disgruntled patients and unscrupulous lawyers, burdens doctors and healthcare facilities enormously. Patients must ultimately pay this cost. Malpractice reform and limits on awards would provide enormous savings in medical costs; however, lobbyists for Trial Lawyers groups will fight this to the end. This group makes huge annual contributions to select political campaigns.

So, Doctors–where does it hurt most? And is your pain getting better or worse? The old joke was that “It only hurts when I laugh. Doc.” Some politicians are unquestionably pleased with themselves today. I doubt that you’ll find many doctors laughing. I also doubt that you’ll find many patients laughing in the future about the state of our healthcare system. It’s very sad to watch. Ours was once the premier healthcare system in the world.

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