Does your doctor work for a boss? Does that boss have your health or profit as the primary concern? %% George A Quittner MBBS, 27 March 2001
Hippocrates spotted the problem long before the first computerised scanner was scammed. Included in the Hippocratic Oath is a vow to let no third party come between a doctor and his patient.
In Australia we have corporations buying up traditional medical practices. Do they do this to improve the health of the patients? No. Like any good business, they do it to make as much money as possible... and what of the doctors who sell their practices? Is their main concern for their patient's welfare? .
Right now we have some nice conscientious doctors moving into the big Medical Centres ...but what will happen in the future? What will be the choices for the young doctors training today? Once the big medical corporations have sewn up the hospitals and the pathologists and the radiologists and all the other "ologists" ...there will be nowhere else to work but for the big boss. Never again will doctors be able to work for themselves, and that means they will not be able to work for their patients.
Health maintenance organistions (HMO'S) in the USA* have already proved that vertical integration and restriction of trade have reduced the quality of medical services available to Americans. If that could happen in the "land of the free", then the Aussie battlers are in for a tough time at the hands of the new "investors" in medical big business.
The "24 hour" Medical Centres never stayed open for 24 hours - There was no money in it. The medical centre doctors rarely do house calls for the same reason. The bosses who run the new medical corporations will soon set about reducing costs and services along similar lines.
In medicine as in every other area of human endeavour, it is diversity and competition which brings about quality and service at a reasonable price. The lack of diversity in medical practices as they are swallowed up one by one, will bring a end to competition and its healthy offspring - quality.
If you like the idea of a family doctor who is available to meet your personal needs - Then support your local General Practitioner. They have already disappeared from many parts of Sydney. Only you, the patients, can stop the rot....
I reproduce below an exerpt from the musings of a family doctor(Dr Ron Risley) in the U.S. working under managed (corporatised) care:
The Doctors' Side -- Patients might be surprised at the conditions under which many doctors practice in our high-pressure, managed care world. For example, you might think your doctor has a plush office with a large desk, telephone, computer, and a clerical staff to handle filing, correspondence, and the like. Reality can be far different. My family practice clinic - at a prestigious university medical center - has a single large workroom (euphemistically called the "doctor's lounge") that serves as an office for nearly the entire practice. About forty doctors share three telephones and four small desks (no drawers, lockers, or other space for personal files or supplies). We have no clerical staff - I personally handle every phone call, letter, prescription refill, fax, or government form for my patients. There are a few Windows 95 computers in the lounge, but they are maintained by the university's Information Services Department and have a downtime approaching an astonishing 80 percent. Worse, all medical records are kept on paper in a central warehouse. Reviewing a record requires that you request that it be delivered to the clinic, where it often gets lost long before it finds you in the crowded workroom.
Time is another constraint. Our salaries are based on a forty hour workweek, but to meet minimum productivity requirements and other mandatory commitments while providing a decent level of patient care often requires over seventy hours per week. Our schedules have no time allotted for "non-reimbursed patient contact," which generally means answering telephone calls.
Physicians in the clinic use various strategies to cope with these primitive conditions. The most common is to limit patient contact to a scheduled office visit, when records are available and some time (often ten minutes or so) is specifically allocated for patient contact. This approach ensures some resources are available, but I feel as though it places a burden on patients, who cannot even ask "Should I take this daily medication in the morning or at night?" without scheduling a visit, waiting weeks their appointment, waiting hours in the germ-infested waiting room, and handling the costs of parking and a copayment.
(Taken from Tidbits: see - http://db.tidbits.com/getbits.acgi?tbart=06392)