Patient-centered Medicine

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Who should decide and who should pay for your medical care?

One of the most fundamental teaching concepts that physicians are exposed to the Hippocratic Oath. In taking the Oath, we swear to first do no harm as we work with our patients and attempt to help them. The second is that we will not consider cost or profit in determining what the patient needs. As doctors our oath requires us to treat someone in the best manner possible to get them better. Other elements of our medical system do not operate under this same premise. For instance, insurance companies do not really operate to provide care for you, they operate to make a profit and to keep as much money in their own pockets as they can. Doctors are often at cross -purposes with insurance companies in attempting to treat their patients under the guidance of their training and the Hippocratic Oath they have taken.

This week, Brett and I are discussing the critical need for people to become informed and understand the role the insurance companies now make in the medical decisions of your doctor, and in the future the role of government in your personal relationship with your doctor. There is a tremendously important conversation going on today within the medical, economic, and political communities that revolves around the questions of rationing of services, lowering the minimal medical care that is required to treat each patient, and making the personal medical decisions of your doctor more like an assembly line. The question is, is a global decision made at the level of government, without your individual needs considered, the way healthcare should take care of people? How do we solve the conflicts between what we spend and do as a society to provide the best medical care to our large community, and what to do in our personal contacts with individual patients? As consumers, as citizens, and as patients, we hope you will become involved in an informed way as participants in this conversation. As someone once said, if you do not become a part of the solution, you most certainly will become part of the problem.

Government regulations that limit or require behaviors from licensed medical providers, insurance companies that limit or require behaviors from contracted providers, or insurance companies that sell medical insurance contracts to individuals and groups that limit or require behaviors are all attempting to define what constitutes provided medical care to individuals. Doctors are a minor part of that conversation, but they are impacted in important ways by the conversations. I believe my relationship is with my individual patient and that the government and the insurance companies should not be intimately involved in making medical decisions. Yet I acknowledge the reality that there is a government function in the area of licensure and regulation and that there are financial concerns between or among all of us as a society. Our system is not perfect and should be changed, but more lay decisions and fewer doctor-patient decisions is not the correct decision. Because it is America, in every part of our life we are able to choose where we want to spend our money. If it is on four-wheelers, a big house, or anything else, we are able to decide what we pay for. Some of us want to be able to pay for excellent healthcare and give up other luxuries, and some would rather buy a New Lawn mower or an SUV. In terms of paying for the care that a patient receives or does not receive, should always be available, and we as a society should pay for citizens who are extremely ill and unable to pay, but the rest of us should be able to choose our healthcare without the help of insurance or government.. I do not believe in being a passive recipient of the decisions of others. I hope you do not either, and that you will become involved in contributing to these conversations.

Please listen to our podcast to hear our reflections on these topics and join our conversation.