Can This Health System Be Saved?

This past Wednesday, I participated in this lovely idea that has been implemented at Studio 620 in St. Petersburg, FL. Studio 620 is a place where art and activism meet. They offer everything from theatre to social events. I have spent the past year volunteering there when I can as it is a great place to see local art and meet great people. About five years ago, they started the idea of a social justice roundtable where they have discussed everything from immigration to environmental issues. This past Wednesday they discussed the issue of health care reform.
The premise was that they ask specialists in the area of health care law and culture to speak on whether or not there is an answer to our current issue of our health care system. Being a physician, it was interesting to not see anyone who particularly works as a physician in a healthcare setting. The first thing that came to mind was if physicians were scared to talk on such a topic in public after this summer's debacle of town hall meetings. I was even hesitatant to say anything as people began to get very passionate about their health care and their anger towards physicians. This is when it occured to me that it is why we might never save this health care system.
Two things have happened in this country that has not happened many other places. One, healthcare became a profitable business and industry. Two, people are not able to distinquish between what is fair and appropriate healthcare. With the invention of the internet and global communication, people have become their own experts on healthcare and want their physician to fit into their idea of what is right. The problem that arises is that what is right for one person is not right for another.
Here is an example. A great show that I love to listen to is This American Life (thislife.org) on National Public Radio. ( I highly recommend it.) They told a story about a physician who decided not to perform a Prostate Specific Antigen on a patient due to the new research out that states that is not as reliable as people once thought. He went over the pros and cons with the patient and let the patient have the final word. The patient agreed with the physician and did not have the test performed. One year later, the patient saw another physician who performed the test and the patient ended up being diagnosed with prostate cancer. The first physician was sued for malpractice as it was deemed that the PSA test was the 'gold standard' of treatment.
Without getting into all the specifics of the malpractice and whether the physician is responsible for the outcome of this man's health. The main point is that the physician fit his treatment plan to fit the patient because the research stated it was not a valid test. But the health care system was still operating on the 'old' set of rules. This is the problem with any huge system. Change is slow to come and even when it is initated, most people are resistant. Where are the incentives for physicians to make change when they might be met with resistance. The same goes for patients.
People say they want a health care system but really what people are saying is that they want a emergency or chronic illness system. People rarely talk about wanting preventive medicine. A friend told me last night that in China, physicians used to only be paid when you were healthy. If you were sick, it was their responsiblity to fix you. The system we have now lives off people getting sick. No sick people, no need for hospitals. How many people do you know wait until they can take it anymore and go to the emergency room to be 'fixed'. Wouldn't it be nice to live in a world where health was a right just as your freedom is. That when you were feeling great, you still went to your physician because they were able to provide you with some form of therapy that helped keep you that way?
That is what complimentary alternative medicine (CAM) practicitioners do. We are here to keep your health and not take it from you. Our health care system is definitely in need of a re-organization, and perhaps in a perfect world it could include an ounce more prevention than it currently does.