It’s Time To Fire Your Doctor?

I was just blown away when I read this article the Wall Street Journal. It is such a perfect example of the disrespect we physicians are getting. The title is It’s Time to Fire Your Doctor by Andy Kessler. Here is Andy’s bio:

Andy Kessler is the author of Inside View, a column he writes for The Wall Street Journal on technology and markets and where they intersect with culture. He is the author of several books including Wall Street Meat and Eat People. He used to design chips at Bell Labs before working on Wall Street for PaineWebber and Morgan Stanley and then as a founder of the hedge fund Velocity Capital.

So, obviously, he truly is qualified to give advice in this area, right? Here is a summary of his thoughts with mine in parenthesis:

  • Let’s say you, like me, are one of the 20 million Americans who work for themselves—no boss, but also no corporate-tax deduction for health insurance. The smart move is to get a high-deductible insurance plan. Now it suddenly matters what doctors charge: $500 to take your blood pressure and bang your knee with a rubber hammer, $1,200 for a blood test that uses pennies worth of chemicals to tell you your hemoglobin levels are fine. Plus four months to get an appointment, and then the doctor asks you to fax an authorization. What? It’s 2019. It’s time to fire your doctor. (Dude, you just made the case for Direct Primary Care. Get a high deducible plan, pay the membership fee of $80, there is no cost for the BP check, $10 for the HbA1C test, and get in the same day with no extra office fee. DO SOME RESEARCH, ANDY!)
  • He has a Fitbit, an Apple Watch, an Omron BP cuff, home labs through WellnessFX, a Beautyrest Sleeptracker and he is all set to fix himself. (I like toys too. It’s what you do with that information that counts, Andy. It’s like someone at home playing the Stockmarket on his computer and calling himself an expert.)
  • When you do get sick, you still need to see a doctor—they have that prescription pad. But insurance companies tired of overpaying for five-minute doctor visits have begun setting up alternatives. Sutter Health runs walk-in clinics for $129 a visit. Online care is cheaper, so Anthem Blue Cross encourages customers to use LiveHealth, a videoconference platform, for $49. Aetna has a deal with Teladoc, a $4.5 billion public company, for $38 consultations. No pain meds, of course, but almost everything else. (Insurance companies are tired of overpaying for five-minute doctor visits? Dude, they caused the five-minute doctors visits! You just proved whose pocket you are in…the insurers. Then you extol their virtues. And your answer are walk in clinics that they want manned by LELTs. You get what you pay for.)
  • Technology has moved so fast that several smartphone-based platforms now function like Uber for doctors: Doctor on Demand, PlushCare, Amwell and MeMD are cutting into primary care. These are gig-economy doctors who provide care on demand for, well, gig-economy workers and others without employer insurance coverage.(Go ahead and keep your “Gig Docs”, who don’t know you and will give you anything you want. I guarantee most of them suck and are just in it for the money. And why is it that tech people always think they are smarter than doctors and that tech will put us out of business?)
  • Taking charge of your health care can be complicated and is not for everyone, but it’s doable for most. I’d stick with services that hire doctors from top 25 medical schools. (Oh, yes, you are so brilliant. The other medical schools are bad, I guess? Your tech is the answer to discover all your medical diseases but it can’t find another way to find better doctors?).
  • For now, when you inevitably and repeatedly fill out the prescreening paperwork, specialists always ask for the name of your primary-care physician. I put down “Dr. Webb.” (What a disrespecting douche you are. A hedge fund guy, who never truly helped anyone else, now belittles the most noble profession. Wow.)
  • Data, data, data—the more the better. As I write this, I have a Fantastic Voyage-like capsule near my stomach transmitting pH levels. How cool is that? As this technology progresses, more tests and more capsules will fill databases with personalized information. (More data? How did the full body CT Scan fad go in the past? That was a lot of data. And a ton of false positives. Good luck with your pH monitor. That will tell you a lot. Actually, I can’t stop laughing as I write this.)
  • The revolution is coming. But not from your doctor. (Uh, yeah, there is a revolution coming. It’s called Direct Primary Care, by DOCTORS, where we go back to the roots of our profession and give comprehensive, accessible and personalized care).

I am just amazed at the arrogance of some non physicians. People have no problem hammering what we do and then get offended when we defend ourselves. Whether it be these tech idiots or LELTs, somehow we have to be careful pointing out our years of training and education that separate us from them. Can we work together someday? Sure. But when you start out saying doctors are not needed, or we are just as good as them, then you are itching for a fight.

Lastly, Mr. Kessler, why do doctors go to other doctors if they are not needed? You would think we could just use all the tech and our training to remove our own doctor from the equation? We don’t because we are not that egotistical to think we can do it all. And we are not idiots.

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