Reflections of a Medical Ex-Practitioner, by Dr. Ed Marsh

Wall Street Journal, April 7, 2013,… great article from the personal experience of Dr. Ed Marsh, who now raises Christmas trees in Massachusetts.

Key points,

  • Originally, from medical school into private practice the goal was medical care for individuals, not treatment of populations or groups.
  • In the mid-70′s, things changed as third parties, typically insurance companies, were interpolated between the physician and the patient, with unfortunate consequences.
  • Since patients weren’t paying for things anymore, ‘more’ became the expectation, and procedures, tests and second opinions proliferated, and the consequences of profligacy disappeared.
  • Insurance relationships drive practice relationships; as more physicians leave health care, the most important factor is not economics , but rather ‘the glow of the personal relationship one might have with one’s patients is being extinguished.’
  • “The medical economist Rashi Fein observed in 1986 that there are only three ways to limit the extravagant demand for medical care:  “Inconvenience,” the practice used in the military, where one must wait interminably for care.  “Rules,” the third-party approach by which layers of rules and thousands of regulations are devised, most recently in a fool’s quest to contain costs under ObamaCare.  And “Price.” This last option elicits gasps and chest-clutching from bien pensants who insist that all financial impediments to care must be removed.  Yet it has one incontestably beneficial attribute: It requires the physician to study the true cost and benefits of a course of action, and then to present that data to the patient.  Who is better suited than the patient to assess the value to him of the proposed treatment?  Kathleen Sebelius?  You gotta be kidding.”

Well said, Mr. Marsh  Hopefully your trees appreciate you, since your patients have been deprived of your care.




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