One Doc's Prescription For Health Care Crisis: Fewer Tests And More Time With Patients

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Sean Palfrey, a pediatrician and professor of clinical pediatrics and public health at Boston University, gave the annual oration last week before the Massachusetts Medical Society in which he boldly (he described it as "hairbrained") laid out a three-part solution to fix the nation's health care crisis.

Do read the entire speech — it's thoughtful and far-reaching on how medicine has changed and the dangers of the current system. But if not, here's the bottom line, according to Sean:

1. Docs should stop ordering unnecessary tests and procedures ($700b/yr according to the
CBO) and spend more time with patients

2. All health and medical industries should become non-profit, plowing all money back into patient care services

3. All malpractice should become no-fault. (I know, I know, now he's gone totally nuts.)

Here's a taste of the speech:

In this new world - on the wards and in the ICUs, in clinics and practices - all of us, to varying degrees, hurry past our patients toward the bottom line, more results, more tests. Almost everything important to us is on-line, in a box or in the cloud. Despite huge reservoirs of human warmth and dedication, doctors are distancing themselves from their patients. We take histories and do physicals and transcribe them into an electronic template. That’s where the patients live. They are stored, their data arranged and rearranged, like avatars of their child-hosts, sometimes almost real.

Within our lifetimes, science and technology have redirected our focus away from the patients themselves. Daily, scientists are discovering the most basic mechanisms of normal physiology and pathophysiology at the molecular level. Often, within months, these findings are translated into tests, images, and new procedures, each one more expensive than the last. This is so fantastic that we all want to know it all, and take advantage of the new knowledge – well before it’s clear how useful this information might be for our patient management.

Unfortunately, over these past decades, our health care system has permitted, even encouraged, all of us to alter our practice of medicine to embrace these new options without the necessary discipline. Because manufacturers and insurers are by and large competitive, for-profit companies, incentives, and few disincentives, have been created for doctors to access new products and see them as essential to good practice, and consumers look for every benefit they can get covered, without knowing the risks and benefits, or fiscal consequences.

And he concludes:

You and I have huge responsibilities as clinicians. Some of the most basic, day to day problems are ones only we can change. And we have to swallow our pride and work with others who can help us. We all want to be the best doctors in the world for our patients, but we are obviously failing in the current system. There was a well-known creature in our house as our children were growing up named “Not-me, Not-me”. But it is us. If the well-being of our patients is really our top priority, then we are the people who must make these changes through our own day to day practices. If we don’t, someone else will make them for us, because the country can’t go on like this for long. And then, no one will be happy.

This program aired on December 6, 2011. The audio for this program is not available.

Rachel Zimmerman Twitter Health Reporter
Rachel Zimmerman previously reported on health and the intersection of health and business for Bostonomix.