Mixed Messages for Health Care

Two recent newswire stories caught my attention. One article noted that there will be a significant shortage of doctors as “baby boomers” hit their 60s and 70s. The other story noted that too much health care is unnecessary and harmful.
Am I the only one who saw a contradiction here?

The second story, sent to newspapers by the Associated Press, noted that “More medical care won’t necessarily make you healthier—it may make you sicker.” The article went on to report that as many as one in three medical tests and treatments aren’t needed.

Fewer medical tests might not be a popular idea among people who keep asking their doctors to identify the cause and then to treat their aches and pains and other health problems. But I would agree, at least to an extent – conventional medical tests and treatments are overused, while nutritional assessments and treatments are sorely underutilized.

In the United States, medicine is a “for profit” business, and most doctors earn a living through some sort of intervention, such as by prescribing a drug or doing surgery. When a patient asks for help, his expectation is that the doctor will do something. Of course, doctors are trained to intervene, and income is related to ordering more tests and doing more interventions. Sometimes the result is iatrogenic disease – physician-caused illness.

Although I believe most doctors are sincere and do want to help their patients, they also know the economic realities of medicine. But not everyone is so sincere. Some years back, I happened to be meeting with a hospital administrator on the morning the government announced that it was reducing Medicare payments to doctors. The administrator was livid. “Do you know what the doctors are going to do?” she asked rhetorically. “They’ve got big mortgages and boats and kids in college. They’re just going to wheel in more patients so they (the docs) don’t have to take a cut in income.”

So, do we really need more doctors? Or unnecessary tests and treatments? Or do we need more doctors who think in terms of more efficient and lower cost nutritional therapies?