Friday, May 20, 2016

Family Medicine: Time for Radical Innovation. Are We Up to It?

The innovation which is needed to get through the modern healthcare mess should be radical, not incremental. Currently, healthcare is money oriented and data driven.  Patient autonomy seems to be ignored via "Bonus-Based Medicine" driven by financial incentives and misguided "Quality Initiatives".  The calling to be a physician who served patients in a relatively sacred patient - physician relationship has been replaced by the job, secured by the contract, cluttered with consumer-clients (formerly called patients).

Don Berwick, MD wrote recently in JAMA that the current data driven era in healthcare should be replaced by the "Moral Era".  The Moral Era needs medical stewardship, appropriate use of scarce valuable medical resources.

G. Gayle Stephens, MD, one of the founders of Family Medicine, wrote of the importance of the counter-culture role that Family Medicine should play in the academic medical centers.   "But the constant is the skill of patient management.  One cannot be a Family Physician without highly developing this skill.... the sine qua non is the knowledge and skill that allows a physician to confront large numbers of unselected patients with unselected conditions, and to carry on therapeutic relationships with patients over time."

Dr. Stephens also warned of the current era of healthcare years before it happened.  "Recent developments are inimical to the role of the physician as healer.  We are developing an erroneous assumption that health care is a product and that the health problems of the population are remediable by medical technology."

It's time for Radical Moral Innovation--Medical Stewardship!

What do you think?

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