What is going on with your healthcare system?
Many of my patients ask me why I think the healthcare system is in such a disastrous situation. Besides the last several years of COVID flip-flops, the opioid scandals, drugs being pulled off the market and the decades of nutrition flip-flops, many are finding that increasingly even their trust in their own doctors and care teams is rapidly fading. Many patients have found that hospitals and hedge funds have bought out their private practice doctors, they cannot even get a live human on the phone or get an appointment in a timely fashion. But this disintegration of care has been occurring for quite some time.
It’s actually quite insidious and represents a complete capture of doctors.
Some may have noticed:
- The Journal of the American Medical Association and the New England Journal of Medicine have begun focusing on climate change and the ethics of meat consumption, meanwhile, thousands are still dying from chronic diseases. This represents a political shift from human health and our failures in it to more abstract concepts of planetary health and the even more obscure ethics of nutrition.
- A prominent doctor was recently fired from Mayo Clinic for talking about his opinion on the differences in adolescent sports performance based on gender. Now, post-pandemic, we continue to see pressures on doctors to conform. During the pandemic, this pressure came from the government and medical organizations but now it’s coming from the private sector, in this case, an academic institution.
- The Hippocratic oath typically taken by medical students, in some schools, has changed to include other ideologies. This represents the immense political and ideological pressures being placed on our physicians.
- That physicians are becoming less and less interested in the outcomes of their patients and more and more interested in guidelines & reimbursement set by insurance companies.
It seemingly starts in medical school. Medical students are being taught codes for insurance. Sometimes medical residents know these codes better than their knowledge of potential life-saving treatments. They are taught medical coding instead of motivational interviewing techniques and cognitive behavioral therapy that can be used to help sustain chronic behavior change in a fight against chronic disease. Few if any medical students or residents have seen type 2 diabetes reversal and yet they routinely see and use insurance codes, ICD and CPT codes. It’s a shame.
Decades have passed and thousands of physicians have accepted insurance companies into their practice and yet chronic disease has worsened. In doing so, Physicians have agreed to the discounted rates from insurance companies in exchange for volume and a patient panel, and what physicians did was degrade their value of care and see patients in less and less time. The average physician interacts with patients for about 7 minutes. There is no way to meaningfully address chronic disease in 7 minutes.
In large institutions and hedge-fund owned practices, physicians are left to count their RVUs, which is the AMA and Medicare’s way to value doctors & pay them. And yet, while they focus on RVUs, seemingly physicians and our institutions ignore real innovation and actual results. In fact, doctors have outsourced clinical results to Pharma, almost exclusively. What physician group has dared to actually demonstrate their clinical results? Other than us?
Physicians seem incapable of improving biomarkers and disease outcomes WITHOUT pharma.
The end result?
A devalue of the doctor-patient relationship.
But there is hope.
There are pockets of doctors that are innovating. We have a movement in the Metabolic Health space with The Society of Metabolic Health Practitioners.
Doctors are eager to demonstrate their value to patients, employers, and the medical literature. Doctors are leveraging apps, educational videos, podcast, they are innovating and connecting patients with meetings, and groups to help spread information asynchronously and creating communities around improving health.
One thing is clear.
The government cannot fix healthcare. Insurance companies cannot fix healthcare. Pharmaceutical companies cannot fix healthcare.
It needs to be physicians and their patients. We need to bring back demonstrating true clinical results to our patients so that we can battle this mounting system of interests that seeks to profit off and not heal our patients
If you have any questions about metabolic health, don’t hesitate to contact our dedicated team. We are committed to helping patients and the community understand how lifestyle changes can improve their lives, while avoiding distractions and misinformation that can hinder your progress.