How To Fix Our Broken Medical System
“Kiss me. When I’m getting f&$%ed, I like to get kissed a lot.”
Al Pacino in Dog Day Afternoon.
Far be it for me to start praising anything from China that’s not over 2,000 years-old. And yet, much more recently they got it right when it came to the relationship between patient and physician. For many years the Chinese state-run system was such that the physician got paid when he kept his patients healthy. If they got sick, he got less.
Now that’s what I call true capitalism. Do a good job, get rewarded. Screw up, and no checky-checky for you.
This system exemplifies what we Americans call ‘accountability’, but at its highest level. Such a method requires a physician who, whether he is caring or not—and bedside manner is ultimately less essential than curing a patient — to be on his toes when a patient is ill. Why will he do that? His money is on the line.
When is the last time a physician in our culture had to be accountable so that his paycheck was on the line?
So, among the 1001 other reasons that our medical system stinks, let’s add one more: lack of accountability. Sure, our bodies break down, especially as we get older, so that obviously has to be taken into account, as do congenital issues, or all the other things that can go wrong with peoples’ health. Noted and accounted for. Then what exactly are we talking about when we bandy about the word ‘accountability’?
Baseball pitchers have what is called an ERA: An Earned Run Average to chart their success/fail rate. Here’s my proposal: Anytime a doctor within a specialty misdiagnoses a condition, performs an unnecessary or botched procedure, or prescribes the wrong medication, this gets noted and placed in a data bank. Once the physician’s EWA (my acronym for a made up term: Earned Wellness Average) hits a ‘red zone’, his methods are reviewed by an impartial board. If found to be consistently at fault he/she is placed on suspension. Four suspensions and you get sent back to the minors. This may mean working on the indigent for a small stipend, until you have proved you’re worthy of treating the general populace. Screw up in the minors 4 times, you are released and given a waiver for fifty per cent off on classes to Butcher School.
These guidelines would apply to acupuncture and other alternative methods. We’re all in this together.
In the healing game, trust is crucial. But those in a position to know better have at times abused it in a way that recalls other forms of abuse. Let’s bring trust and accountability back into the conversation. Because the current state of our medical system recalls that line by Al Pacino in Dog Day Afternoon.
Daniel at Blue Phoenix Wellness