What is wrong with healthcare?

The rising cost and the decline of quality healthcare has someone like myself upset with the trend. There are a few major factors that play a role. I am going to discuss some of these factors below in hopes to help inform the public of why it is so important to self advocate for the care you deserve. 

“Medicine is a science of uncertainty and an art of probability.” (1)

I begin with this quote to help explain modern medicine in very few words. The most important word to process is the word, “uncertainty”. The lack of acceptance with this word is a major flaw in the healthcare system and leads to some of the issues we deal with. The following discusses some of the ways that uncertainty impacts healthcare cost and the quality of care.

Medicine is not black and white. In school, medical professionals are tested with multiple choice questions. Questions that have one right (or less wrong) and 3-4 wrong answers.  Test questions dip into the grey but not enough to help the students understand the importance of how grey the professional world can be. This undoubtedly increases the likelihood that medical professionals will perceive uncertainty as a threat. This perception will bleed into how they interact with and treat their patients in the future. With this mindset it becomes more and more challenging to accept uncertainty. It feeds the fire for the search for specific diagnoses and black and white answers. Uncertainty in medicine also factors in when we see different outcomes from the same treatment on different people with the same diagnoses. We hope for positive results but we aren’t 100% certain of the outcomes. That can be scary not only for the physician but also the for client. 

Unreliable research. Much of what we study in medical research is backed by sub-par outcomes and poorly performed studies. We are not willing to admit that there is too much that we don’t understand and it is hard work and dedication to stay up on the most recent research. Many medical providers don’t possess enough humility to adapt and change with the times. That being said, the unreliability of medical research has us questioning who to trust and what to believe. 

Over-medicalizing. Running multiples tests just to check boxes is what I mean by over-medicalizing. Many tests ordered are unnecessary and simply are performed to check boxes for insurance companies or because the physician is following an outdated protocol. In the world of pain management, the unnecessary tests can lead to unnecessary diagnoses. Many of the “abnormal” findings on tests are actually normal parts of the aging process and have poor correlation with symptoms. 

Physician burnout. This topic is a factor, two-fold. The first as to do with the decline in reimbursement rates and the increase in the number of people in need, medical professionals are forced to work harder and harder. The are pushed to see more clients per hour and complete more paperwork than ever before. Both of these factors contribute to a decline in the quality of care that physicians are capable of. The second factor involved here is that if physicians can not embrace uncertainty, they will continue to look for black and white answers, which continues to emphasize the black and white mentality, driving them to the point of questioning why they practice medicine. 

  1. Bean RB, Bean WB. Sir William Osler: aphorisms from his bedside teachings and writings. New York: Henry Schuman, 1950. 

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