Letter to the Editor: Market-driven patient care serves no one well
Friday, January 26, 2018
As a practicing physician for many past years, even I had not fully absorbed the slow destruction taking place on our health care system until recently.
As I cared for a loved one in a hospital setting, I am struck by how backward it has become: impersonal, uncaring and, in the ﬁnal analysis, ineﬀective. For patients, this kind of experience is both frightening and alienating.
This has nothing to do with technology or human failing. It seems to me that care workers have in many ways resisted this trend, but they have become trapped structurally.
First comes the centralization of care is such that one has to travel miles out just to get care. Where community hospitals still exist, they are constantly under pressure to turn a proﬁt to remain open, which translates to greater workload on all health care workers to maximize “eﬃciency.” This creates a shrinking ratio of caregivers to patients, and does not allow adequate attention to be paid to any single patient irrespective of need. Proﬁt over humanity drives patient care to be patchy, and caregivers overworked.
Care has been fragmented as specialization increased, forming subspecialties within subspecialties. The human patient is divided and subdivided into smaller and smaller parts, with the ultimate eﬀect that no one caregiver feels capable of treating nor responsible for the whole. Treatment is always deferred to the “specialist,” while in-patient care is entrusted to “hospitalist” doctors who work shift-to-shift with no prior relationship with the patients they treat. This creates an obvious risk for information being missed along the way – at times leading to fatal mistakes.
The constraints of our commodity-oriented society – where the market is everything, and patient care is subject to its whims – works well for neither patient nor caregiver. The feelings, needs and desires that come with being human are secondary. Stated simply, our well-being is being traded for proﬁt. An outcome is that relationships between caregivers and patients become distant and impersonal, and at times, adversarial.
Meanwhile, millions are denied access by reductions to Medicaid and Medicare ﬁnancing, while the cost of health insurance premiums hit the roof. What we need is a system where everyone gets the care they need, not just “access to coverage.” This has been an ongoing struggle for the 99 percent and to me, it cannot be ignored – especially with increasing attacks now on social justice on every front.
Dr. KIM E. KOO