Friday, 20 January 2017

Concierge Medicine, can it improve health care?

   The whole health care system is so sick and inefficient that it is difficult to imagine how it can be repaired without first drastically reducing the multiple layers of parasitic bureaucrats and health care administridiots who enjoy generous salaries and benefits, without making any contribution to health care. They will only attempt to reproduce their own kind and to increase and perpetuate their power.
   There will be no single universal solution to this massive and complex problem.  It will take a multifaceted approach to make any significant inroads in averting the disaster that we are racing toward.  Concierge Medicine may be one small to medium sized step in the right direction.
    What on earth is that you may ask?   Its other name is retainer medicine. It is a relationship between a patient and a primary care physician in which the patient pays an annual fee or retainer.  In exchange for  the retainer, doctors provide enhanced care and that includes a commitment to limit patient load, so that each patient will have adequate allocated time and ludicrous concepts like 'only one complaint per visit' will not be possible.  Guaranteed availability is an important aspect of concierge medicine and although details vary from group to group, most strive for same day or at least next day appointment and consistency of coverage on a twenty four hour basis, three hundred and sixty five days a year.   If you, the customer are buying it, you are entitled to know exactly what you are paying for.  The government takes your money and expects you to be grateful for what you get.  The unmitigated gall and brazen effrontery of your government is that they dictate what you can (or rather can't) buy with your own money.  They certainly don't tell you that you cannot buy high priced organic foods because you think it is better for your health, because all can't afford it or that you can't buy a better health food supplement than many can't afford and if they did, the LWLs  (Left Wing Loonies) would be screaming.
    Have you ever tried to get hold of your doctor for something that a short telephone call or even an email might resolve?   In my last years in practice I couldn't even get my own nurse on the line, my call was automatically flipped over to her answering machine.  I used to joke that the telephone had become an instrument for the avoidance of conversation with a live person.  That's not the way it used to be.  Most nights I used to bring home a stack of phone calls to make after dinner.  Physicians don't do that anymore.  Most Concierge physician groups are offering to do that and have someone available  around the clock for phone or  email consultation.  Can you imagine how many emergency room visits that saves and because emergency room visits are disproportionately expensive, how much money that it would save the public health care system?  Can you imagine the convenience of being able to pick up the phone to discuss whether you need to be seen right then or whether you could just drop by the office in the morning and know you could be seen without waiting three hours?  But government and bureaucrats don't want you, the public to know how easily many of the three hour waits in crowded unhealthy emergency rooms and subsequent two week waits to see your doctor could be avoided.  They just want you to think you are getting excellent health care and be grateful, when we rank eleventh out of twelve in developed countries. 
    So do we have any concierge clinics available in Canada.  You bet we have, but they keep a very low profile, because once they come to the notice of the College of Physicians they are accused of contravening the Canada Health Act and are put under notice that unless they stop they will be put under suspension.  The government, the Colleges (licensing bodies) the OMA hope to keep the dismal state of the health care system under cover for as long as possible and most of the folks don't care about it until they themselves or their families are impacted by it. 
   The bottom line is that the government of Canada, the Health care bureaucrats and all of the sycophantic organizations that help support them want things to stay exactly as they are.
    As one character in  Mel  Brooks hilarious movie 'Blazing Saddles' said, "gentlemen, we have to protect our phony-baloney jobs".  
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