The Problem With Doctors

People are mad that government might get between them and their doctor. There is one problem with this concern though: there are a lot of lousy doctors out there.

I keep hearing about how people are mad that government is intruding on a terra sanctum--healthcare, which should remain between a patient and their doctor, with no external intrusion (of course that's what insurances do regularly, but that's another conversation). The simple bottom line is that it actually hurts the system when that is left to the free market. Doctor shopping, and patient wooing, has little to do with delivery of appropriate care, but rather stylistic preferences. I've seen quite enough of it from the sub-specialist perch I'm on.

Simply put, there are so, so, so many lousy doctors-- and not what patients call lousy doctors (e.g., poor communicators) but I mean people with bad judgment who, frankly, need someone telling them what to do more. They make bad decisions, and as a side issue, fiscally lousy decisions. Rationing, imposed standards, and increased waits, believe or not, would improve the health of our country substantially, because it would require people to think, and use evidence, and be less likely to OVER-treat, as well as being less likely to under-treat. As a side benefit, it would likely massively cut costs as well. But no one likes to talk about it, because no one wants to face the reality of just how bad medical decision making has become in the hands of the holy doctors. There aren't nearly enough studies, but there are plenty, which show that the knowledge and judgments of a ridiculous percentage of providers is truly substandard, and the requirements for continuing medical education are a joke.

Perhaps the free market could make this happen, and I really wouldn't care if it were the government or the free market. But there will be an intrusion one way or another, and I would hope people's health could actually be the driver of the motives for the intrusion.