Something's Gotta Give

Quote of the Day:

I quit practicing medicine in 2003 at the age of 43. Burned out. Like most doctors I went into medicine with a lot of idealism. The first half of my medical career was in the Army (they paid for my medical education). The second half was in private practice.
In the Army system, a single payer system, I was free to focus my attention on patient care, as were my colleagues. Conversations between doctors revolved around the latest medical research on how to best care for our patients. I never thought about how much money a particular treatment option for a patient would earn for me - I was paid a salary and it was the same no matter what treatment options I chose. I never had to deal with getting an insurance company to pay me for my medical services after I had already given them. I never had to argue with an insurance company after they denied my treatment plan for a patient as "medically unnecessary."

In private practice I was horrified to see how money was the driving force behind everything doctors did (do).

...Worst of all, I saw patients routinely suffer from unnecessary, expensive, and often harmful treatment interventions that were clearly chosen because they earned the most money for the doctor and the hospital.

I even had the bizarre experience of having an insurance company try to convince me to pursue a series of invasive surgical procedures in a particular patient instead of the much less expensive exercise program I had recommended because the series of surgical procedures was in their algorithm for treating the diagnostic code I had assigned the patient and exercise wasn’t.

...I agree with Dr. Krugman - there is no place for “free market ideas” in medicine - at least not if you want your doctor to actually take care of you.

-Monte Ladner, M.D., responding to a blog post by Paul Krugman.