On the other side of this great divide, we have the "little guys." These are the cowboy doctors who continue to bank on the utility of their education, experience, and ability. They are pushing to slim things down, eliminate the excess overhead and meaningless metrics that drive up costs and instead focus on high-touch personalized medicine. Bring the relationship between you and your doctor back to the forefront. Recognize that seeing a patient as nothing more than a series of data points up until she finally visits with you in her moment of highest need is in fact, not a great way to go about providing high quality care. Instead, it allows for greater fragmentation, lesser degrees of trust, and an erosion of the patient-physician relationship.
The more I find myself looking at evolving trends in healthcare through this lens, the more intrigued I a about which side will ultimately prevail. On the one hand, the industrial complexity of healthcare as big business is certainly where the resources lie to continue investing and frankly, even forcing patients into these models whether we want it or not. Alternately, the cowboys are relying on the extraordinary dissatisfaction patients feel about the idea that they have become just a medical record number, a set of data points in someone's productivity metric, with little attention to how they truly feel after their interactions.
I know that for my highest need (usually = sickest) patients, I am fearful of how much will be missed as they are forced through systems of fragmented care where the primary care physician's role is increasingly slimmed down rather than expanded to given us greater opportunity to really hear our patients, understand what is important to them, and see what is being missed.
What will our systems of care look like when this division is complete? And which side do I want to be standing on - as a doctor or as a patient?
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