Medicine today: A brief Disertation.

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Although not directly written on the topic of Glycomics. It speaks to the tip of the ice burg, with understanding that the current medical trends dictate the efficacy of research proliferation.
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Medicine Today !

In monitoring patient populations, both existing and potential patient groups, it becomes obvious that certain factors impede positive patient/physician interactions.

Some of your competitors have discovered that prompt service and easy access are two things patients want most. Accordingly, they’ve fashioned their practice after a model called concierge medicine. An annual membership fee accords a patient 24/7 cell phone or email access and same day appointments. The idea is to limit the member-patient population to a number that a physician can accommodate on that basis.

Such a proposition seems attractive to patients. And it is easy to see that a physician whose current patient load could easily exceed 5,000 would gladly restrict it to 1000 patients in exchange for the assurance that he or she could start the calendar year with $1.5 million already in the bank. Nevertheless, this model has not fared well with those with whom we spoke.

Other physicians have lined up behind the American Medical Association as a standard bearer of the profession. Unfortunately, the AMA is now airing TV commercials that advocate a national health insurance model for America.—a model that, as we can see in Canada, winds up rationing healthcare as a result of escalating volume.

There is another trend which has usurped the authority and hands-on caregiver image of the physician, and that is the Hospitalist movement. This movement has, almost overnight, replaced the presence of primary care physicians for thousands of hospitalized patients The goal of the hospitalist is to reduce “excessive” hospital stays to a more “efficient” duration of 72-96 hours—and they are incentively compensated for doing so. Since hospitalists are employees of the hospital itself, the standards of third party payers can be met, which allows maximal benefits to be paid despite the abbreviated length of the patient’s stay.

Almost to a person, patients decry the fact that their primary care physician is not the one in charge of their care; that the person who is in charge is one with whom they have no relationship. In a time of injury or disease, a time of dire need, a total stranger is the one standing at their bedside—oftentimes advising their family about Do Not Resuscitate measures, Hospice care, and other End of Life issues.

In a larger context, Internet technology has given patients access to information regarding the benefits and side effects of pharmaceutical medicines. It has also become obvious to news savvy individuals that a great deal of controversy overshadows the FDA, the CDC, and the ever escalating profits of the pharmaceutical industry itself. This has caused individuals to question both the purity of motive and the credibility of safety assurances, especially in the light of such scandals as Vioxx and Celebrex. Anxiety has also escalated over the news reports of MRSA infections in hospitals (and now appearing more and more outside of them) and the ineffectiveness of most antibiotics to hinder them.

Further, serious cost discrepancies between drugs in the USA and Europe or Canada have added substance to the suspicion that US pharmaceutical companies are more motivated by profit than patient benefit. The fact that other countries as nearby as Mexico, permit patients to purchase many pharmaceuticals over the counter, or with the sole advice of a pharmacist—has added to the dissatisfaction.

The outcome of all this has been an erosion of public confidence in the medical community as a whole. Sadly, physicians often bear the brunt of this waning confidence, not because they are culpable for any of it—but simply because to their patients they are the only face of the medical profession.

Even from a physician’s point of view, healthcare policies seem weighted more toward writing prescriptions (a benefit to pharmaceutical companies) than toward office visits to the physician. Higher co-pays and deductibles have also curtailed physician visits and contributed to the demand for more prescriptions and less personal connection.

Meanwhile, the media campaigns speak directly to patients in their homes, assuring them the best chance to curtail whatever disease they have been labeled with is to “ask their doctor” about a specific drug. In a parallel campaign, physicians are encouraged to label patients as “pre-diabetic” and “pre-hypertensive”—and to prescribe pharmaceutical treatment preemptively, even before they fully express their “disease.”

It is unfortunate that physicians to whom Americans have entrusted the care of their very lives have abandoned (if they were ever aware of them at all) any reliable sources for prevention of the maladies that enslave their patients. Instead, they recommend yet another “pill” that has typically un-discussed, but predictable side effects. Neither do they alert the patient to possible interactions of multiple meds or the consequences of nutrient deficiencies those medications may induce. Indeed, these are areas in which physicians have limited, if any, training. So it is possible for patients to experience negative consequences which neither they, nor their physician, fully understand.

In the light of these circumstances, is it any wonder that physicians have lost a measure of credibility and authority in the public eye? Has the erosion of trust between healer and those seeking health given rise to a public hope that with a National Health Insurance, “at least the government, the Congress, or the President will look after me?” Are those of us in medicine somehow driving our patients toward the fantasy that big government will provide for its people from the cradle to the grave?

We at McKenna Project would like to make a stand for the reestablishment of the traditional physician/patient trust relationship. It is our position that all expense for healthcare (including preventive wellness care) should be tax deductible, funded from pre-tax savings. Patients should be able to stand before their doctor of choice and offer to pay for their care, resuming their position as the sole negotiator of their benefits and determiner of how they will be treated.

This reordering of the relationship (and the dissolution of the employer’s ability to dictate who pays for what for their employees) will also eliminate the revoking of benefits with the onset of a life-threatening illness or injury. Instead, patients can be given the same tax exemptions that the employer now enjoys.
In this world, patients can interview physicians and offer to pay a set fee for all visits with a minimum of two to four per year. Inherent in this agreement would be a requirement that the physician be expert and up-to-date in his or her knowledge re the risks and benefits of all drugs; that they be utilized only when they are absolutely necessary; that the physician will divulge information relating to his or her pharmaceutical investments, and will promote alternative means to maintaining optimum wellness in terms of scientifically researched nutritional supplements, diet, exercise, and safe health practices.

Finally, it is up to physicians to welcome and encourage efforts on the part of their patients to positively pursue wellness at every level. In return, the physician will agree, in the case of illness or injury, to exhaust every avenue possible to keep the patient out of the hospital.