Have you ever thought about the fact that when you walk into an art gallery you are drawn to certain artists and the works they have created? This idea that in art one size does not fit all also applies to healthcare. We see numerous articles about how we as Americans comparison shop for our cars, dishwasher and almost anything else you can find on Amazon or other websites. In her article for Real Clear Health on the future of healthcare, Seema Verma states, “Our demand for a value is the engine that drives competition which, in turn, lowers prices and inspires innovation to improve the quality of the products we purchase.” She goes on to say, “Yet, when it comes to one of the most important services we receive- our healthcare- this consumer driven engine sputters.”
Is healthcare becoming a commodity that is driven more price then by quality? There are some very legitimate reasons that you could argue that price ought to be a priority. The fact is that healthcare in the United States according to the Center for Medicare & Medicaid Services in 2017 reached $3.5 trillion, averaging $10,739 per person. This healthcare spending currently accounts for 17.9% of the Gross Domestic Product, yet the disparities in quality of care remain vexing in the American healthcare system. Even the healthcare systems considered to be preeminent have disparities in quality in the multiplicity of specialty services they provide. Will consumerism solve the problem by both driving down the cost of care and improving the quality? If you presume that one hospital is like another and one physician is as qualified as another your answer should be yes.
Thinking of healthcare delivery as more than science, but also as the art of diagnosis, is pivotal to a good outcome. Having a price list for procedures will have an impact on the wide disparities being charged by providers, particularly for surgical procedures. However, the quality and competence of the provider should be the first question asked. It is ironic that in almost every other facet of our lives we take quality into account when determining if a product or service is being fairly priced. Yet, in healthcare we have almost no benchmarks to utilize to make that determination even if we are putting our life in the hands of this facility or individual physician. Particularly today when the number of employed physicians is expanding geometrically employed doctors are incentivized to refer their patients within the system. Thus, even your primary care physician with whom you have built a trusted relationship receives pressure to refer to the best specialist within the system and not the best available.
With all of these competing pressures within healthcare today, the discerning patient needs an advocate who will navigate them through the maze of competing interests. Very often at Curus, we see individuals who have been provided with limited options by their PCP because of these referral constraints. When we begin to discuss multiple options that may better serve their needs they are surprised by the set of choices they really do have.
The reality is that the science of healthcare is becoming more precise and effective. Once the diagnosis is made, the science of how to cure that illness is initiated; and the best advances in technology and pharmaceuticals do their job. However, if the art of diagnosis is mishandled, all the technology available will not lead to a cure. This is the critical issue that makes those diagnosticians who listen, see and evaluate their patients so valuable. They are the artists in the health care system. After all the analysis, shopping for quality healthcare cannot be compared to buying a dishwasher. Medicine is more than just a commodity easily picked off the shelf.
We could write volumes about why the healthcare system is so expensive, but it will never answer the ultimate question of finding the right physician. That is because, as much as we increase our reliance on technology, the nuance of a great doctor is that physician’s ability to read between the lines. We at Curus pride ourselves in understanding the artistry of medicine. We always seek to find the physician who will understand the patient and connect with them in a way that accelerates the likelihood of their recovery.
