“Whether you think you can, or think you can’t, you’re right,” said Henry Ford noting how our mindset shapes our behavior. Now, let’s talk about our American mindset on healthcare, which is that “more is needed” and that doctors are the most important players.
In a recent message to all physicians, Dr. Cecil B. Wilson, former president of the American Medical Association, calls on us to help take vigorous action to solve the growing crisis of too few physicians.
Dr. Wilson wants to expand medical schools, lower the cost of medical education, and create a new mechanism for funding graduate medical education. He claims it will be “not only unacceptable,” but “morally reprehensible” not to take strong action to increase the doctor supply.
As a physician and a member of the AMA, I don’t think this is a good idea for a lot of reasons. First let’s get real, and admit that the overwhelming majority of healthcare in America is rendered for preventable conditions.
Resources would be better spent on prevention.
Let’s help people change their lives, not just sell them more healthcare. The healthcare system is selling healthcare, when what we need is health.
Whether you think you can, or think you can’t, you’re right,” said Henry Ford, whose introduction of the Model T automobile revolutionized transportation and American industry.
In addition, a significant fraction of healthcare has been judged useless or harmful, and doctors clearly are capable of creating their own demand. Why do hospitals always want more procedure-oriented specialists on staff?
It’s simple, when the doctor supply goes up — the amount of care, and the profits, rise too.
I’m not blaming physicians for this problem, the causes of inappropriate care are complex, but if we just got rid of unnecessary care, would we have a “physician shortage?”
Lastly, historically doctors have acted aggressively to protect their turf – both as a profession and within specialties. How much routine healthcare could be rendered by nurse practitioners, nurses, pharmacists and other more numerous and less costly providers?
Studies suggest that a huge fraction of care doesn’t need to be rendered by a doctor, but what prevents this? You know the answer — the physician lobby.
In aggregate, America spends more on healthcare than other societies and gets less for it.
We’ve spent more on healthcare each year for decades, yet we still think we need more? The “physician shortage” is a creation of the physician associations and the way we collectively think.
However, if you think as I do — that health doesn’t come from healthcare; that we should be working to have more health and less care; and that non-physician providers can do much more — then there is no “physician shortage.”
So with all due respect Dr. Wilson, the “physician shortage” is in your head.
Peter J. Weiss is an internal medicine physician and former health plan CEO. He is author of More Health Less Care and can be reached at More Health, Less Care: Building America’s Wellness System.
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