Medicine and pest control are in the same business. Customer service! We share all the same practices and procedures to conduct our businesses. Doctors examine patients. Exterminators inspect buildings. They diagnose the problem. We identify the pest. They prescribe a treatment. We prescribe a treatment. They perform the needed service. We perform the needed service. They recommend a preventative maintenance program. We recommend a preventative maintenance program. They use chemistry in the form of medicines. We use chemistry in the form of pesticides.
There's a reason why many pharmaceutical companies manufacture pesticides. Both are designed to generate a biological response to get a desired result, and the research can have interesting corollaries. But the differences between medicine and pest control really become pronounced after that, and education not-with-standing, it's all about costs and attitude.
John Stossel recently posted an article entitled, Free Markets Would Improve Hospital Service, saying among other things:
"I fill out long medical history forms by hand and, in the next office, do it again. Same wording: name, address, insurance, etc.This is one of my pet peeves. Filling out - by hand - copious amounts of paperwork - with all the very same information I filled out in the very first form. I understand each component of the medical profession needs it's own paperwork or they wouldn't be able to charge me.....Oh My! But why can't that information be automatically transferred to the proper form with a touch on the key board? Then all I should have to do is confirm it's correct and sign it. Too easy?
A number of years ago I had some stomach discomfort....not pain....just discomfort. This started on a Thursday and I went home early. I didn't go to work the next day but didn't go to the Urgent Care Center either. That evening my wife insisted I had appendicitis. I insisted I had no pain....just an uncomfortable full feeling. Finally about an hour before the Urgent Care was to close at 9:00 PM I went in. The doctor seemed completely puzzled there was no pain because based on his experience he absolutely believed it was appendicitis and insisted I go to the hospital. He even called them to let them know I was coming.
I was impressed!
When I drove there - and the fact I drove to Urgent Care and then to the emergency room was another surprise for all of them - I guess you're supposed to have so much pain with appendicitis driving is out of the question. At any rate, I've been there before and they had my records and filled in the necessary information, so there was no issue at this point. I arrived about 10:00 got the blood test out of the way and was scheduled for an ex-ray. I was told I would probably have all the preliminary stuff done before I even got into a treatment room.
This being a Friday night the emergency room was busy, including some poor young kid with a broken arm. But I wondered - who does the triage in these places? Isn't a potential appendicitis attack serious? But since I really wasn't in pain I wasn't particularly concerned that I didn't get into the treatment room until midnight, or had my x-rays taken until 2:00 AM. At 4:00 AM I was told I had "flaming" appendicitis and the doctor was called and I would be operated on in the morning. I was pretty casual about it all, and they all kept looking at me strangely. At this point I guess I was supposed to be in agony. In reality......I was just glad to get off that darned uncomfortable gurney and into a bed.
After I got into a room I told the nurse I was supposed to be operated on that morning; did she know what time that would be? She didn't! Two hours later the same question, and at eleven I said if I was going to be operated on this morning they better hurry as the morning was fast disappearing. Each time they said they never know until they were called to transport the patient to surgery.
I went to surgery at 1:00 PM.
They did a good job, took good care of me, and I was glad my appendix didn't burst. But there's the rub. I checked myself out of the hospital after two days ..... they don't like that. It appears they don't think the hospital is a hotel where you can check out of when you please. Wrong!
As it turns out the insurance was willing to allow me seven days in the hospital. Why? Thinking my appendix didn't erupt I later found the charts declared that to be "inconclusive". I asked "what's that mean?" As it turns out that probably means the appendix had already been leaking and was close to erupting at the time of the surgery.
So it only took from 9:00 PM on Friday until 1:00 PM on Saturday for my "flaming" appendicitis to be fixed. I am truly glad I wasn't in the kind of pain they talked about. Interesting customer service.
But back to Stossel's view about free markets improving service. I don't believe that! I'm a free market person, and I believe competition can make it cheaper, but it won't make it better. I'm almost 70 years old, and it's been my experience doctors and hospitals have always been arrogant. They've always kept patients waiting. They've never been forthcoming with information. in short - medicine has always stunk when it comes to customer service, and why? Because so many have God complexes? Because many believe we're all stupid? Maybe - but the real reason is because they can!
Malpractice has leveled that a bit, but it's also created a much bigger mess with unnecessary tests, higher costs, and even less willingness to share information than before, and we still have to sit and wait and we still have to fill out copious amounts of repetitive paperwork - by hand. Normally I would understand that because there's no way of knowing how long you may have to spend with a patient. But when they schedule numerous patients for the same time - that's arrogance and poor customer service.
In spite of all that, I do believe it can be made infinitely worse by socializing it and turning it over to civil service unions. That's what's happened everywhere else and there's no reason to believe it would be any different here.
If we really believe medical care in the U.S. is broken let's start fixing it by reducing costs by ending all these outrageous medical payments on liability lawsuits, and most importantly ending so many of these lawsuits that are nothing short of scams. Attorneys like former Vice Presidential candidate John Edwards, made vast fortunes being nothing short of "ambulance-chasing attorneys" who've colluded "with jackpot-seeking perennial victims in looking for the judges elevated from attorney status to issue their munificent blessing and ravage the insurance-carriers." "It's not the doctors who are the problem; it's the lawyers." "This scandalous rigging of the justice system is at the heart of the health care problem in the United States."
"If the conservative movement demands serious tort reform, then we can break the stranglehold the jackpot liability solicitors have on the American legal and medical systems and find our way to a more affordable health care system."
Let's start there, then we can start looking at creating cross state insurance programs. Is competition is the key? We need to find out. One writer claims that's a red herring and recommends "a legitimate recommendation for Congress: Stop the tax code’s discrimination against individually owned health insurance." But powerful forces fight against that! Ask anyone in Ohio who says they want to reform our expensive workman's compensation program. Organizations supposedly representing small business will cut your lungs out for saying that because they get a cut of all that money by offering workman comp programs, at a group rating discount. A system found to be totally corrupt.
Another writer expains why the Georgia experiment for interstate medical insurance failed and why over the long haul interstate medical insurance will be a blessing. And while I like the tax issue raised by the previous writer - I'm a believer in competition as the answer to costs.
Ask the state of Wisconsin what happened when the Act 10 stripped benefits from union negotiations and they no longer were required to buy their insurance from "the WEA Trust.... created in 1970 by Wisconsin Education Association Council (WEAC) to provide insurance and benefit plans tailored to fit the needs of their members—Wisconsin public school employees and their families. Those costs were going up until competition emerged....and then they went down.
Maybe all these ideas can make medical care cheaper, but let's understand this - the medical profession will always be arrogant and show poor customer relations. It's part and parcel of who they are. Pest controllers will always be better at customer relations than medicine and we will always make less money. That's part and parcel of who we are.
No comments:
Post a Comment