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The Industrial Age of Medicine Is Over


Modern medicine is broken. There are too many sick patients and far too many unhappy doctors to think otherwise.

Modern medicine is broken. There are too many sick patients and far too many unhappy doctors to think otherwise. We have more heart disease, cancer, diabetes, obesity, and depression than ever before. There are more people with autoimmune disease than cancer and heart disease combined. On top of that patients are not happy with their doctors and they are taking these frustrations out on us and our staff.

On the flip side, doctors are also struggling. The role of the private practice is being destroyed as doctors leave their office settings to work for hospital systems or larger corporations. Many, many doctors are dissatisfied with all of the administrative, insurance, and government bureaucracy that causes us to wonder what medicine really means anymore. Malpractice premiums are rising at the same time that insurance reimbursements are falling and diminishing.

On both sides of the coin, we now have a scenario where our beloved medicine has changed for the worse and both we and our patients are struggling to know what to do next. Throw in the uncertainties related to "Obamacare" and our anxieties and frustrations are compounded.

It is not hard to trace the roots of the medical system demise - it certainly parallels what has happened with our economy and society over the last century. The industrial mindset has dominated our economy, our school systems, our political systems, and our medical system as well. Many of us grew up believing in this system - go to school (obey the rules), get a degree (obey the rules), and then get a job (obey the rules). This industrial mindset that allowed for the factories to make the rules for the workers is exactly what happened in medicine where the doctors set the rules for patients.

Patients wanted this because this is the system that we all believed in. In medicine, this system flourished once antibiotics became a valuable commodity. Now instead of the patient and doctor working together to help heal the patient, the pharmaceutical drug became the Holy Grail. Doctors became masters of these drugs and the pharmaceutical industry blossomed beyond belief. Of course it was not limited to just antibiotics - soon after, we had hormones and antidepressants and antipsychotics and blood pressure medicine and cholesterol medicine.

Now the patient would do as the doctor said (obey the rules) and take their medicine because that is how we defined health. This worked for a while. We went to medical school and were trained how, when, and why to prescribe these pharmaceuticals. Patients were trained to believe that when they are sick they need a drug to get them better. And we invested our time, energy, and resources proving over and over again with double-blind, placebo-controlled studies that evidence-based medicine is the path to follow to better health for all.

But like our economy and society today where this industrial mentality is failing us beyond our comprehensions, modern medicine can no longer be sustained with this type of thinking. We know this is true because both we and our patients are dissatisfied and worse feeling because of it.

Sure, modern technology is to be embraced and there certainly is a time and place for pharmaceuticals - there can be no denying how great an impact they have made. But to continually blame others (insurance companies, government regulations, patient non-compliance) for the current state of our much maligned system without taking responsibility ourselves is a huge mistake.

We are as much to blame as everyone else involved. We all understand that medicine is not going in the direction we all want, but I feel that we are missing the larger and broader points. Medicine needs a new set of rules for us to follow. We have to start focusing on our patient relationships in the exam room above all else. We have to stop relying on drugs and surgeries to define what we do.

Because, ultimately, we and our patients want the same thing. We want to feel a connection, to have an interaction with our patients like they want from us. One patient in one exam room, one at a time. This is how medicine started and this is what we need to turn back to in order to get our medical system back to a place where healing can occur again.

There are many facets of our medical system that need improving, but they all improve if we start focusing more on what goes on inside the exam room, than what transpires outside of it. The industrial age of medicine is over and it is time for us to start leading this way.

For more on Craig Koniver and our other Practice Notes bloggers, click here.

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