Take It Back by David Fitzpatrick MD
I appreciate you taking the lead on the sad state of the business of medicine. I feel that medicine is doing great…not so much the business. I want to share with you a thought that comes from me via a friend at an unnamed company that rhymes with schmoogle. He reports the history of the past few decades in the high tech world showed that it began with brilliant engineers producing valuable miracles and the business schmucks making ALL of the money.
At some point, the STEM (science, technology, engineering, math) folks realized that they were being raped. They realized that having their name on a patent or award was neat but that the business guys had all of the money. All they wanted to do was to make their miracles, but in failing to focus on the big picture, they handed control over to greedy people.
My friend reports that his and most of the high tech companies now put the money and control in the hands of the miracle makers and ‘just go to Harvard and buy a bunch of MBAs and make them fill out the forms and run the business side of the business’.
Will it take a union or some form of collaboration to give docs the power to take back control? It will take a collective state of mind that we don’t take medicare/caid/private to make changes in the system. Fee for service is OK for lawyers. Why not take it back?
Problem is that FFS as a compensation model for lawyers is under serious challenge.
I like FFS as a model for PCPs since most people only see their pcp 2-3 times per year, possibly 8-10 x if they have problems. and those with worst problems end up being managed by specialists.
Exactly. FFS is the only way I’ll practice medicine. Otherwise, I’ll either retire or do something else.
Alas, we will not “take it back,” for the same reason that we did not “take back” the gobbling up of Poland during the Second World War. Germany and the Soviets divided the whole country, back when they were pretending to be friends.
It is hard to pull one’s self up to the table during a turf squabble by tyrants. I’m sure no representatives of the Republic of Poland were invited to the partition of Poland according to the Nazi-Soviet Pact. Now, if it truly were a diplomatic discussion, there would be a representative from Poland’s government there to lend ideas and insight.
And the chopping up of Poland certainly did make for some nifty art – see http://upload.wikimedia.org/wikipedia/commons/8/84/Alegoria_Umarlej_Polski.jpg for a picture of Poland at the Deathbed.
But the pact has been inked, and it’s up to the lookers-on, such as the doctors, to come to understand the New Order. We may know that it will not last – it is madness. But it is the way it is.