April 26, 2010
Over the last two days, my articles have focused on the cost of healthcare in America. “Duh” covered the revelation that more expensive care leads to a decrease in death rates. “ACO” reviewed how Medicare expects to cut the cost of healthcare by rationing service.
Today, I want to spend a little time on the topic of specialty medical care. First, I need to explain what I do. I am a Family Practitioner, trained in general medical care and fulfill the role of PCP (primary care provider). I am trained to know a lot about everything. My predecessors, the general practitioner (GP, Marcus Welby, MD) did everything from delivering your babies, to operating on your appendix, to pronouncing your grandmother. My training is similar. I used to deliver babies. I’m trained to take out your appendix. I work hard at keeping your grandmother alive so I won’t have to pronounce her.
I know everything about a few things, a lot about a lot of things and something about almost everything pertaining to your health. The most important thing I know is what I don’t know. Knowing what you don’t know and where and how to find the answer is critical in healthcare. My specialist consultants’ jobs are to know what I don’t know and to take over when you and I need them.
Wise counsel is one of the most important tools in any endeavor, particularly so in medicine. I use my consultants liberally. Even when I know what the answer is, I may bring in a consultant for reassurance. After all, I am human and capable of error. My consultants are expensive! Their time and skill set is highly specialized. Their opinion is just as highly valued and may save your life.
In today’s medical environment, my consultants bring more than their opinions. My consultants bring life saving technical skills as well. My cardiologist can slip a stint into a closed artery and restore lifesaving blood supply to a dying heart. My radiologist can block an artery to a tumor, killing the tumor and saving a life.
ACOs, the insurance industry and Medicare want me to return to my Marcus Welby roots. They want me to be a gate keeper, restricting your access to expensive care. Can I function without highly trained specialist and expensive test? Of course I can. I practiced in villages in Mexico where I didn’t even have electricity. Should I return to the era of the GP and practice as your sole provider? I think not!
You get what you pay for, right? One of the best investments you can make is getting a second opinion from one of my chosen specialists. By the way, I choose independent thinkers – doctors who, when necessary, won’t hesitate to disagree with me. Debate amongst providers of care is healthy. Often, there is no definite right or wrong way to accomplish a goal. Finding the best way to health involves exploring many opinions.
“Knowledge is power” is a central theme of this blog. Obtaining knowledge can be expensive. Expensive care leads to better outcomes. Better outcomes mean better health.
May you be so blessed as to never know the disease you prevented.