Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why health reform will destroy the e-patient movement

Jordan Grumet, MD
Physician
October 16, 2014
Share
Tweet
Share

The e-patient movement represents everything that is positive in medicine today.  This grass roots force has introduced shared decision making and empowered both physician and patient.  The quality of health care dialogue has risen meteorically both in the exam room and out.  Today’s health care “consumer” is more engaged, more intelligent, and more agile at wending their way through the confusing maze of sickness and health.

It’s awfully sad that it has to come to such an abrupt end.

While you may accuse me of hyperbole, there is plenty of reason to believe that the gains made by this important and patient-centric revolution will fall victim to the machinations of health care reform.  How could legislation made to benefit the populace have such untoward effects?  Its all about intentions.

The architects of the Accountable Care Act and the mountain of legislation that will follow were faced with the difficult task of allocating scarce resources to a growing and unsustainable national debt.  Instead of an open and honest conversation of rationing, the beltway answer was to hire a group of medical ethicists to convince us that population health is more important than the doctor-patient dyad that has been the basis of medical care for centuries.  Thus physicians become the steward of the population, allocating these resources as they see fit to benefit the community.

This version of health care is the complete antithesis of the e-patient movement.   Medical decisions are not inclusive, not patient-centric, and not up for debate.  This is the ultimate form of paternalism.  “The doctor feels that your expensive chemotherapy does not sufficiently benefit society.”  There is no discussion.

Such statements would be almost laughable if not for the recent article by Ezekiel Emanuel in the Atlantic.  According to this prominent author and proponent of Obamacare, you (and society) will be better off if nature takes it’s course swiftly and promptly if you are over seventy five years old.  And why not?  Zeke tells you it is so.

The e-patient movement extols taking power away from central authorities (or paternal doctors) and placing it squarely in the hands of the patient.  Ezekiel Emanuel can’t divine your values, life goals, or interests.  How can he decide what medical treatments are right for you?

The situation worsens if we consider the new structure of our health care system.  President Obama’s self stated intention was to collect large groups of doctors into big organizations.  These organizations, he reasoned, would facilitate a team-based approach sown together by technology and the abolition of fee for service.  He reasoned that doctors on salary would be much better penny pinchers and stewards of our national piggy bank.

As we have seen across the country, the cataclysmic mergers of hospital systems has created a majority of employed physicians, strapped to computers, and mired in the bog of administrative minutia.  Patients are becoming last in a long line of mistresses.  Physicians answer first to their hospital system, next to their electronic medical record, and then comes the government.  At some point, if your physician has enough time to leave his “team huddle,” he may be able to see you a few minutes between most precious key strokes.  You are an afterthought.  There is no empowerment here.

In conclusion, I think the way forward for the e-patient movement is clear.  You have fought like bats out of hell against the paternalistic, backwards ways of the past.  It’s time for you to turn your attentions to a more sinister villain.

Your government.

Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion.

Prev

As Ebola spreads, what can we do to help?

October 16, 2014 Kevin 7
…
Next

We can make a difference: Lessons from the Buckyballs recall

October 17, 2014 Kevin 0
…

Tagged as: Patients, Primary Care, Public Health & Policy

Post navigation

< Previous Post
As Ebola spreads, what can we do to help?
Next Post >
We can make a difference: Lessons from the Buckyballs recall

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Jordan Grumet, MD

  • The man who changed the world with baseball cards

    Jordan Grumet, MD
  • A hospice doctor’s advice on getting your finances in order

    Jordan Grumet, MD
  • A story of persistence in the face of death

    Jordan Grumet, MD

More in Physician

  • Rediscovering the soul of medicine in the quiet of a Sunday morning

    Syed Ahmad Moosa, MD
  • The broken health care system doesn’t have to break you

    Jessie Mahoney, MD
  • How a $75 million jet brought down America’s boldest doctor

    Arthur Lazarus, MD, MBA
  • The dreaded question: Do you have boys or girls?

    Pamela Adelstein, MD
  • When rock bottom is a turning point: Why the turmoil at HHS may be a blessing in disguise

    Muhamad Aly Rifai, MD
  • How grief transformed a psychiatrist’s approach to patient care

    Devina Maya Wadhwa, MD
  • Most Popular

  • Past Week

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions
    • The dreaded question: Do you have boys or girls?

      Pamela Adelstein, MD | Physician
    • Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
  • Recent Posts

    • Rediscovering the soul of medicine in the quiet of a Sunday morning

      Syed Ahmad Moosa, MD | Physician
    • An introduction to occupational and environmental medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Does silence as a faculty retention strategy in academic medicine and health sciences work?

      Sylk Sotto, EdD, MPS, MBA | Conditions
    • Why personal responsibility is not enough in the fight against nicotine addiction

      Travis Douglass, MD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • Alzheimer’s and the family: Opening the conversation with children [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 42 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions
    • The dreaded question: Do you have boys or girls?

      Pamela Adelstein, MD | Physician
    • Rethinking patient payments: Why billing is the new frontline of patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
  • Recent Posts

    • Rediscovering the soul of medicine in the quiet of a Sunday morning

      Syed Ahmad Moosa, MD | Physician
    • An introduction to occupational and environmental medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Does silence as a faculty retention strategy in academic medicine and health sciences work?

      Sylk Sotto, EdD, MPS, MBA | Conditions
    • Why personal responsibility is not enough in the fight against nicotine addiction

      Travis Douglass, MD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • Alzheimer’s and the family: Opening the conversation with children [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Why health reform will destroy the e-patient movement
42 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...