Yes, healthcare is spiraling out of balance. But can we counter that?
I don't know if you see this but healthcare is spiraling out of balance. Perhaps into self-destruction.
Our industry is a mess. And it's costing us dearly.
How? You ask.
1) We kill people routinely. Medical errors are the third-leading cause of death in the US. But we can't list "medical error" in a death certificate. It's not small. 700 people per day. 251,000 deaths per year. Most countries don't even track these errors.
2) We bribe each other. It's common knowledge in India (and many other regions) that labs and doctors have to pay each other for patient referrals. It's such a norm that many specialists can't survive without subscribing to the norm.
In the US, we use soft money to influence policy and governance.
Pharma companies take doctors on vacations and give them lucrative speaking engagements. The industry hires physician consultants to produce guidelines that are often questionable.
An extremely renowned doctor told me this recently. That a hospital chain requested him to go to press with a certain recommendation. Cardiac catheterization must be performed for chronic disease patients. The plan was to follow up caths with lucrative stent placements. Then everyone would get a piece of the pie.
Thankfully, the doctor I know is super ethical and said no.
What are we doing?
3) We don't allow the body to heal. The body's natural tendency is homeostatis or stability. Having survived for tens of thousands of generations, humanity suddenly shifted gears in the last 100 years. Healthcare became an industry. Fixing from outside-in became the standard.
In the beginning, antibiotics saved millions of lives. Then we realized that we damaged our microbiology almost permanently. Enough that today's generations are born with weaker immune systems (here's a simple test: which baby boomer you know has nut allergy?).
Only recently we discovered that we're 10% human and 90% bacteria - bacteria that we've constantly shot down.
In the beginning, painkillers relieved us from pain. Now drugs like oxycodone have made us into opioid addicts. Killing 91 people per day in the US through overdose.
We are too vain an industry to acknowledge that we know little about the body.Just like we know too little about the universe.
In healthcare, when we see a problem, we'd rather rush to find the hammer. That's a big problem. It's like to trying to build a rocket every time we spot a planet.
4) We create life-long customers out of patients. In most industries, that's a good thing. To develop lifelong customers.
Earlier in healthcare it meant that we'd take our family members and friends to the same doctor. But managed care changed which doctor we could see.
Now we look at downstream revenues from every new patient. We extend chronic disease. We do more procedures. We prescribe more. We do more tests.
That may appear smart in the short term. But in the longterm, patients and doctors are trusting each other less. Aren't they the two main players of the industry?
5) We've messed with what we pass on to future generations. We almost never worry about the impact of the environment in healthcare. Questions about where someone lives or what she breathes on her commute - hardly ever come up in consultation rooms. However, the environment has a strong role to play on what we've become.
From 2001 to 2009, Type 1 and Type 2 diabetes significantly increased among children and teenagers. Puberty age has steadily dropped. A study conducted between 1989 and 2005 indicated a one-third drop in average sperm count. Among the 56 million people who died worldwide in 2012, WHO says that 68% died because of non-communicable diseases (NCDs pertain to heart disease, cancers, diabetes, and chronic lung diseases).
Shouldn't we pause to ask why this is happening?
Whatever we're doing is surely passing on. From one generation to the next. Through our own genetics and our environment.
So, what do we do about all this?
This isn't about social medicine. Or, doing some social impact stuff on the side (one doctor-friend actually asked me if it was).
It's about acting with responsibility.
Many get into healthcare for the right reasons. But are disillusioned midway (most don't even wake up). At that point, you usually choose one of the following options:
a) Drag along doing nothing. You have student loans, mouths to feed, career goals, mortgages and so on. So you decide to play along with the industry. Pushing your instincts under the rug. You convince yourself that you can't do much alone anyways.
b) Leave the industry. Many doctors quit medicine. It's not what they signed up for. So are others. Here's what one former pharma sales rep in the US Midwest wrote to me. I saw the ugly backstage of healthcare. I have left the industry. She worked in healthcare for 15+ years.
May be there's a different option
You would agree that healthcare is out of balance. If not as a worker, as a patient. If not as a patient, as a caregiver of a loved one.
On one side is all the ugliness we know of (refer to the 5 points above). That balance today is outweighing the good we've been doing.
May be we are just naive. We think that we can keep going down this road. And we won't drop off the cliff. Someone will keep finding fixes after fixes.
Healthcare needs more good folks who can stand their ground. Doing good.
Whether you are an entrepreneur or a doctor. Or, a venture capitalist. Or a hospital. Or a lab. Or a marketer. Or medical devices company. Or an insurer. Or a biotechnology firm. Or even the government.
Do great business by all means. But also dare to do the right thing.
Even if it means you'll upset a patient who wants an unneeded prescription. Or your boss. Or your shareholders. Or your client. Or your partners.
Doing good and acting responsibly is actually good for business. That in the end will keep all your stakeholders happy. It will allow the industry to gain back the trust and respect that it's rapidly losing.
Because in healthcare, it's easier than ever to choose wrong. Even if we don't always intend doing so.
