Unintended Consequenses

Unintended consequenses are inevitable when making global decisions in a system as complex as medical care. Unfortunately doctors have ceded too much ground to the bureaucrats and it may be too late to save the system without a complete collapse. Over the past two decades the number of doctors in this country has grown with the population. The number of medical administrators, however, has exploded, and these people now consume a large portion of the health care dollar. The administrators and non-practicing physicians spend a lot of time NOT caring for patients but telling the rest of us what we are supposed to be doing with our time and talents. We now have a number of very entrenched special interests that dominate medicine (i.e. Pharma, device/medical equipment companies, hospital corporations, and the government) with little to no input from physicians and with little thought to the consequences for individual patients.

I could give hundreds of examples of the insanity of the current system, but in the interest of time I will give one: a single example of the mind-numbingly idiotic machinations of “the system” is the fact that inhalers are quite expensive for my patients to the point that people are going without medicine and dying. Why? Global warming!

What? you ask? Now we can argue all day about the amount of climate change going on and how much humans have to do with it, but I doubt that anyone would argue that asthma and COPD sufferers are big contributors to climate change. But that does not matter in today’s insanity. Because of “climate change” big Pharma can lobby to make the propellant gases used in inhalers illegal, so that the reformulations – now required by law – can allow them to extend patents for another decade or so. So the old MDIs are out. Now people have to use these “respi-click” inhalers which are difficult for elderly patients with arthritis. And Pharma gets to charge hundreds of dollars for these new inhalers for medicines that should be dirt cheap.

People get hurt. And I would be willing to bet that if you calculated the carbon effects of creating the new manufacturing plants for the new inhalers the overall balance in the carbon calculations would be a wash, if you even believe the carbon dioxide hypothesis of climate change to begin with.

This is just one small insanity in the sea of insanities that is modern medicine. It is no wonder that good people are leaving the occupation in droves. Why would anyone want to be a doctor today? The prestige is gone. The money is gone. The work is shit and we have to listen to the ‘C’ students who are now hospital administrators telling us what to do. Bad EHRs are just adding insult to injury.

I did see a sign posted in one doctor’s office that I think should be a standard sign posted in all doctor’s offices. “Don’t mistake your Google search for my medical degree”