Everything about medicine is now big business, KevinMD

Med­i­cine used to be different. Doc­tors couldn’t do too much for you. They didn’t get paid very much and they were focused more on helping than on managing a business.

Hospitals were community-based not-for-profit or public entities. Drugs and devices were not as sophisticated or expensive, and they weren’t marketed directly to consumers. Well Toto, we’re not in Kansas any­more.

After witnessing our “health­care reform” process you must have seen that almost every­thing about med­i­cine is now big business. If you don’t know that by now, you’re not paying attention.

Yes there are still some “little guys” out there, but they’re playing by big business’ rules. What does that mean for you? Hang on, I’m coming to that.

Now it’s often said ” the first rule of business is to stay in business.” It’s not wrong either.

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Death in a hospital is not always comfortable, KevinMD.com

In America, too many people die in the hospital.

I don’t mean that they die due to medical error or incompetence, though that’s always a hot topic of discussion amongst doctors, researchers, administrators, and regulators.

What I mean is that if you ask most people, they say they’d rather die at home, surrounded by their loved ones, drifting off to sleep painlessly after having had last rites administered (feel free to plug in your religious/atheistic ritual of choice here).

Why, then, do so many who want this type of death instead die medically, here in the hospital, undergoing painful treatment and the deprivations and degradations of medical care?

The answer has both simple and complex aspects. But I’ll start by sharing something that most medical professionals believe:

When my time comes, the last place I want to be is in the hospital. Don’t get me wrong–I like GlassHospital–it’s a good place to work, teach, and learn. But when the grim reaper is calling my name, I want to be as far away from here as I can.

No IVs. No needle sticks to test my blood. No waking me up to check vital signs every shift. No hospital food. No fluorescent lights.

No feeding tubes; no bladder catheters (ouch!); for Heaven’s sake, no breathing machines (‘mechanical ventilators’).

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The cost of keeping the terminally ill alive, KevinMD.com

Last year, Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients’ lives.

And it has been estimated that 20 to 30 percent of these medical expenses may have had no meaningful impact. Most of the bills are paid for by the federal government with few or no questions asked. This statistic is from a 60 Minutes story on “The Cost of Dying” and is one reason our healthcare system is in trouble.

Modern medicine has become so good at keeping the terminally ill alive by treating the complications of underlying disease that the inevitable process of dying has become much harder and is often prolonged unnecessarily.  The way we set up the system right now, primary care physicians don’t have time to spend an hour with you, see how you respond, if they wanted to adjust your medication. So, the easiest thing for everybody up the stream is to admit you to the hospital. And once someone is admitted to the hospital they’re likely to be seen by a dozen or more specialists who will conduct all kinds of tests, whether they’re absolutely essential or not

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