Preparing for the Future of Medicine: More mechanical? Less personal? Definitely.

I interviewed an insurance professional the other day and was told some rather startling and alarming facts about health insurance. He told me that the whole concept of a health insurance company’s networks is changing. To keep costs down, health insurance company providers are likely to change the members of their networks every year. If you really like a particular provider, you will need to find out each year if that person will be in that insurance network the following year.

But the practitioner won’t necessarily have the right information on this. You will need to check with your insurance agent in October when open enrollment starts.

My take on this change: This shift to insurance company networks is going to absolutely shred the concept of patients being able to rely on a particular healthcare provider. When I was a kid, we had the same doctor for years. He knew our health histories.

The family doctor who treated the parents and then all of their kids is now a thing of the long-distant past. Practitioners will have to rely on electronic medical records. It will get more difficult to establish a relationship of trust with a practitioner.

Part of this change is the opening of so many Urgent Care Centers. For a long time, people who were just sick but not seriously injured have been relying on emergency rooms for help because they could not get appointments with their preferred care providers. ERs started being overloaded and this made it harder to care for the injured or those with true emergencies. Therefore, Urgent Care Centers are being set up to fill this gap. But this means that your medical care—the key to your health and perhaps even to being alive—will have to be delivered by someone who has never met you or your family member before.

To ensure the quality of your care, I believe it’s going to be more important to keep a copy of all medical records you can get your hands on, advocate for yourself and most importantly, get educated on the kind of medical care you want. Medicine, which at one time was an empathetic profession that insisted on high standards of care, is being converted into an automatic machine. You’ve got to figure that a machine is cheaper to run than a group of thinking, researching and discriminating humans.

I’m sure there will be some exceptions to this new, brutal system of medicine, but in my view, it’s going to take more vigilance to get the correct care one needs. The last few years have been a catastrophic example of this new system of medicine. My best possible advice is this:

Get into action on those changes that will make you healthier—good diet, exercise, less stress, more positive experiences, quality supplements and whatever else you would add to this list. 

My opinion: The Standard of Care is going to become everything. Here are two definitions for this term:

  1. Treatment that is accepted by medical experts as a proper treatment for a certain type of disease and that is widely used by healthcare professionals.
  2. [T]he standard of care is a diagnostic and treatment process that a clinician should follow for a certain type of patient, illness, or clinical circumstance. In other words, this is the level of care widely accepted in the medical community…they are the common best-practices adopted by healthcare professionals through a variety of training and education, and ultimately inform adopted protocols.

In other words, if you show up with a particular health problem, your practitioner is required to offer or administer a set protocol of tests and treatments. In fact, if they fail to at least try to administer the proper standard of care, they are liable for lawsuits.

You may have to make a decision not to accept the accepted standard of care if you don’t think it’s right for you. You have the right to refuse a particular treatment. Your provider will document the fact that the treatment or diagnostic procedure was offered and then refused by the patient.

Or you may have to find a practitioner who will work with you to resolve a health problem rather than follow rotely down the path of this standard of care.

One more thought for you. Sometimes, it might be the best move you can make to see a cash-only practitioner from time to time or always. For personal care with someone who knows you, takes time with you and can think outside the standard-of-care box , you might need to go this route. It’s a judgment call for each person. The next best choice might be to find a smart, ethical practitioner who understands the insanity of the insurance system. I’m lucky to have this but it’s getting harder and harder to make appointments with her.

Please prepare yourself mentally and perhaps financially for a more mechanized system of medicine. I can’t think that this change will make our care better, I believe it will make navigating one’s medical care far more hazardous.

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