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Quality, NOT Quantity

By On · Add Comment · In Dartmouth Atlas Project, doctors, health care, health care quality, physicians
Listen up health care reformists: When it comes to mainstream health care–more is less. So says a recent study conducted by the Dartmouth Atlas Project which analyzed data from the government, the American Medical Associations, and the American Hospitals Association. The Project’s findings simply prove my position that America’s health is not dependent on “more health care.”

I recently had a conversation with an ideologue who claimed that what society needs is more health care to serve the people who lack accessibility. I argued, as I do in my book, The Six Keys To Optimal Health, that what we need is less quantity and more quality when it comes to medical care. You’ve heard me say it again and again in this blog that people do have accessibility to health care in this country. Laws exist which prohibit turning patients away, many hospitals have charity plans, and free clinics are readily available (there is a very busy one just two blocks away from my office near Cedars Sinai hospital in Los Angeles). I also argued that no profession will make itself obsolete–a plumber will find leaks, a business consultant will find flaws, a doctor will find…well, doctor stuff. So obviously, more doctors, more sick people.

Here’s what the study showed: Doctors tend to settle in prosperous cities near medical schools where they studied–think San Francisco, Chicago, New York. San Francisco has 117 primary care doctors per 100,000 residents while less affluent El Paso, Texas has 47.2. At the same time, the availability of hospital beds goes down in more affluent communities. Why? Just like I said, more doctors, more medical care, period. That is not the same as need, understand that; in fact, according to Dr. David Goodman, director at The Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire,

“While high hospital and physician capacity drives costs upwards, there are many regions that do well with many fewer beds and physicians per capita. Health systems in these lower capacity regions show that efficiency is a partner, not a competitor, of quality.”

So I reiterate, more health care isn’t what this country needs. What would be more appropriate is efficient, high-quality health care, where doctors aren’t hospitalizing people simply because that’s what they do, but instead where they treat illnesses with scrutiny, efficiency, and great care. Perhaps they might start by minimizing antibiotic prescriptions for viral infections, hm? Now that would be efficient.

Who Are You Kidding?

By On · Add Comment · In children's health insurance, health care quality, medical insurance, wellness
Have you heard? Kids who see doctors regularly get the proper care less than half the time. Huh?! That’s right–a new study conducted by the Seattle Children’s Hospital Research Institute and the nonprofit research group, the Rand Corp., found that children received the right care only 47% of the time. As the first comprehensive test of its kind, this study looked at the health care quality for American children. What was especially disturbing was that every one of the 1,536 children in the nationwide study had medical insurance, dealing a serious blow to the notion that a lack of health insurance is what’s leading to diminished health for our nation’s youth. All this on the heels of governmental debate on expanding children’s health insurance.

Although the study did find children’s doctors to fare moderately well in the assessment and treatment of acute medical problems–they got these right 68% of the time–they did poorly when it came to evaluating and treating chronic conditions (53%), and abysmally when it came to recommending preventative care (41%). According to Dr. Joeseph Hagan, a Vermont pediatrician, “They got an ‘F’.” “It’s sad,” he went on to say, “but I think it reflects some unpleasant realities about our current health care system or, I might say, non-system.”

Basically, what the study found was that there was such a wide variance in how doctors treated some of the most common illnesses, and especially how they “promoted health”. Who would think it to be otherwise? Haven’t you heard me say over and over again that our current medical system is based on a paradigm of fighting illness and saving lives, not promoting health and wellness? There’s certainly nothing wrong with that, except that when one industry pretty much monopolizes the entire health care arena, it’s pretty hard to understand the game (health) outside of what that industry tells us it’s supposed to be. And they aren’t yet focusing on the basics of health and wellness, which is all too apparent from this particular study.

My feeling is that it would be wise for American society to restructure the health care system and put everything in its proper place. The medical industry should focus on treating disease and saving lives–it’s what it does best. The task of teaching and directing the public’s health and wellness, though, should come from where it’s has been coming from over the last several decades: chiropractors, acupuncturists, fitness experts, nutritionists, massage therapists, yogis, hypnotherapists, meditation experts, and every other profession that focuses on health and well being. These professionals are in the best position, and have the expertise, to teach our children the aspects of good health. Leave the medical doctors to do what they do best; and open the doors for the new wave of health experts–real health experts. Kill the monopoly. It’ll be OK–form governing boards and create doctorate programs. You’ve got it!–yogic doctors, doctors of exercise physiology, doctors of nutrition, and such–why the heck not? It’ll guarantee competency and weed out the scheisters. That’s the government initiative I’d like to see debated real soon.

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