First published in 2013, this article continues to be true. Unfortunately, my cronies are retiring, and the private practice of medicine is dying. Admittedly, I sold out in 2018 and went to work for a large hospital corporation. I really had no choice. As a private practice of medicine, I could no longer get reasonable contracts from the insurers and therefore could not survive financially. My employer recognized my physical limitations and treated me well; however, the writing on the wall was clear. I would need to pick up the pace, see more patients per hour and satisfy the computers lust for data if I was to stay employed.
Is medicine a profession or is it a business? To us old timers, medicine is first and foremost a profession; a calling. As such, the business of medicine has always come second. Unfortunately, neglecting the business side of medicine has led to my profession’s downfall.
Fast forward to current times. Medicine has become big business. Companies such as Walgreens have led the charge. Obamacare has led to the creation of Accredited Care Organizations owned by corporate entities and poised to suck every available penny out of my once proud profession. Physicians, Nurse Practitioners and Physician Assistants have become corporate America’s service technicians and patients have become cost centers to be controlled and serviced in mass.
What’s behind the changes in medicine? Profits! America’s leading healthcare companies have figured out the business end of medicine and are going at the business full gun. Pharmacies are now doing acute and chronic care in their Quickie Clinics. Does anyone see a problem here? I certainly do!
In past articles, I have written about the ethics of selling cigarettes in a facility that administers care and medication to sick smokers. Corporate America has taken greed to a whole new level. Apparently, it is OK to help someone develop chronic obstructive lung disease and then treat him for his chronic illness for the remainder of his life.
The treatment of chronic diseases entails more than just writing a prescription. It entails helping the patient develop healthy lifestyles. Will the store front practitioner who is treating a patient for diabetes walk her through the store and show her everything she shouldn’t buy or will the sale on large bags of Reese’s Pieces catch the patient’s eye and will he/she end up with several bags of the sugary delight in their cart? Will the three 12 packs of Coke for $9 sale be the diabetic shopper’s reward for purchasing his/her healthcare at such a convenient location?
Will the store front practitioner walk the hypertensive safely out of the store avoiding the racks of salt-laden chips and pretzels? I think not! Instead, the store designers will continue to set up food gauntlets designed to lead the customer to the most profitable products and fill the corporation’s coffers.
The business of medicine is the end of medicine as us old timers know it. Ethics and morals will change and it will become completely ethical to sell an obese individual a diet pill, a six pack of Millers, chips, pretzels and candy. If you can sell cancer sticks in a place of health, hell, you can do anything!