Do you have several health issues? Perhaps you've found it difficult to lose weight, to eat a healthy diet, to get ideal cholesterol levels, or to quit smoking. If so, you are likely to get dropped from the increasingly for profit medical system in the US.
Private practices are being absorbed by for profit hospital systems, which financially penalize doctors for "difficult" patients who have complicated health issues or are "uncompliant". Business-trained managers, who may not even have a bachelor's degree, control doctor schedules, set guidelines and apply financial penalties.
... slouching into view is more corporate control over the practice of medicine.
The deliberate degradation in the name of profits is going to become more obvious, at least if the health care industry has its way.
The health industry hopes that individual medical practices and small medical groups will ultimately disappear from the landscape by being financially absorbed into larger groups owned by hospital systems.
…the subtext of “standardized” always includes the unspoken “spend less money on the patient.” Thus, a doctor might be financially penalized for recommending nutritional counseling to lower cholesterol (“counseling is expensive”) instead of writing a generic statin drug (cheap).
One physician piped up…. “But what about the non-compliant patients who won’t take the meds, don’t eat well, don’t have mammograms, continue to smoke?
“You’ve got to fire patients like that. Get the non-compliant and the super-demanding out of your system. They’ll drag your numbers down. Hit your personal bottom line.”
In other words, if you are high maintenance because you don’t do what your doctor says (and remember, “non-compliant” includes people who don’t follow orders because they think the cookie-cutter approach isn’t right for them) or ... have a complicated set of ailments, you’ll be shunted. The brave new world of corporate medicine will eject you.
Here's one example:
... a pediatrician, Pauline, who has developed a reputation for treating chronic conditions is at loggerheads with her for-profit practice. The suits don’t like her patient mix. She gets too many tough cases, when they’d rather have basically healthy kids who are there for a cold or ear infection.
She’s constantly breaking management’s precious guidelines. One of her turf struggles: She had set up a visit to see a new medically complex patient and had blocked off 40 minutes, the amount of time she felt she needed to do a good job. The child had a complex genetic disorder, cerebral palsy, and heart, lung, and kidney problems. Both the cardiologist and the nephrologist had called asking her to take this patient. She agreed. After she had scheduled the visit, a manager called her and told her that she was being allowed only 15 minutes to see that patient.
Pauline explained that this manager assigned to her office is not even a college graduate. Physicians cannot access the schedule electronically and have no control over scheduling. These functions are controlled by the office manager and (amazingly) by some of the medical assistants who have received some “leadership” training. These medical assistants are even allowed to evaluate the clinical competency and skills of the physicians.
... this sort of demoralizing micromanagement ... is a widespread shortcoming of management American-style. And it has weirdly been airbrushed out of the media. [emphasis mine]