How can we incentivize the medical profession for keeping us healthy?

Can we find a way to pay our doctors for keeping us out of hospital?
It is not easy to market preventive medical service as it is difficult to convince customers of the efficacy of what is being offered. For example, I cannot with confidence tell a 65-year-old man that I have succeeded in averting a premature heart attack in him – when I might have done that with years of careful monitoring of his risk parameters, corrective counseling and simple maintenance medication.  Such a claim may not be appreciated, and the patient may be wont to dismiss it with light hearted derision. He may even suspect that I suffer from an excess of narcissism.
On the other hand, there is nothing more marketable than relief of pain or other forms of distress. That is why hospitals in general seem to do well. Hospitals may do nothing to prevent diseases, but this is hardly ever an issue with most patients.  When you have a serious problem like a heart attack, a stroke, a bad infection resulting from uncontrolled diabetes - and you are admitted in a hospital for several days and then get discharged in a better condition, you will be naturally grateful to the hospital and the doctors. You will not, in the normal course, hold them accountable for not having taken adequate measures to prevent you from getting these conditions.
Health is integrally bound to balance, lessening of inequality – within the individual as well as in society - and needs to be measured in terms of health and well-being of individuals, cleanliness, beauty and lack of pollution of the environment and the happiness of those who live as a community.
Everything that leads to 'feeling healthy' needs to be consumed only optimally – and this includes food, medications, health supplements etc. Even time spent with a healthcare professional or in a hospital, invasive tests and interventions and so on.
Now the problem is that healthcare having become an industry has adopted the strategy of maximizing consumption of health services by the community.  Effective community health care needs to have a system that is completely outside the business structure and should aim at optimizing the utilization of services and medicines instead of maximizing consumption. Unless we devise an economic system where what is valued in healthcare is not profit, but the health of every individual in society itself - where the aim of monetary profit or a better bottom line is replaced by health of the community itself - there will be no future for healthcare.
The aim in medicine is to treat people who are ill, not organs with disease. Organs don't develop disease, it is the whole individual who does. A disease may signal its presence mainly through symptoms that appear to center in a specific organ, but it would be inaccurate to say that the organ is diseased when it is the whole organism that suffers.  Organs and systems are not discrete ‘things’ but only concepts that we have developed for the convenience of articulating and teaching.  
Every ‘organ system’ can be seen to integrate seamlessly with other ‘systems’ to make up the organism - so that anything that happens to an organ tend to initiate a cascade of events involving all organs to variable extents. The current practice of specialization in specific organs is therefore fundamentally flawed. Doctors cannot afford to become specialized in individual organs, they can only be skilled in procedures of treatment – such as endoscopy, angioplasty or surgery. Procedures play a part in holistic healthcare, but cannot substitute the care of the individual – and this is an indivisible process that every doctor regardless of specialization should be expected to be skilled in
Society should aim to create a sustainable service that doesn't treat healthcare as a consumer service in the same way as other goods and services are dealt with in the free market. We therefore propose that only thing that can be consumed maximally in the field of healthcare is 'optimal care' itself.

Dr G Ramesh Kumar


© Copy protected by CitizenzNews ©



  2. I do agree with these points brought up by Dr Ramesh. We need to bell the cat. Much to be done in the present scenario of medical practice and public health . Proper awareness to the reading public is a good start. Wishing you all the best
    Dr A Rajkumar MBBS MD MFAMS

  3. I read sonewhere that in the New York State health system, there is a proposal to make hospitals bear the costs in the case of readmission within a certain period after discharge, if it is for the same complaint.


Thanks for stopping by and caring enough to comment.Anyone with a Google account can comment.

Also, please subscribe to this blog if the content pleases you.

Powered by Blogger.