We’re hearing a lot about practice guidelines these days. It is touted as making a medical practice more cost effective. The primary goal is to improve the bottom line. Otherwise, how can the shareholders and CEO’s command their millions.
Phil Alper, MD, reports that in France, the “Order of Physicians” (initially created by the Vichy Government during the Nazi occupation) was instructed to create a cookbook listing “appropriate” guidelines for ordering tests and medication. It leans heavily on office-based physicians and spares the more politically powerful hospital sector, even though the latter consumes nearly 60% of the health money.
French doctors are terrified! Computers have made mathematical criminals of doctors without any awareness of wrongdoing. In the first two months of the program, dozens of doctors have been fined thousands of dollars.
If this sounds familiar, it should. The same distinction is happening in this country without “The Vicious Government” even being involved. Managed care companies and doctors working for hospital foundations or HMO foundations are increasingly separating the doctors who work entirely in their offices and those who take care of hospital patients. The data touted is that this is more efficient and more cost-effective care.
This theory doesn’t hold water… as most physicians are aware. The government has singled out doctors they can control, and those doctors are office-based practitioners rather than the entrenched hospital doctors. Hospital-based doctors may know that they will be the next group under scrutiny. But in their desperation, they hope they can be out of medicine before that occurs. The tragedy continues.