While the media and Congress like to focus on the cost of healthcare here in the U.S., the real issue is the failure to treat patients as people rather than address their health conditions. Every patient is different, and what they hear from their doctor varies. Can our healthcare system really treat patients as individuals?
Pete had a challenging career. He worked for the Post Office and had a walking route encompassing a vast one-mile hill. He walked that route for over eight years, which put a lot of strain on his knees. He would eventually leave his job on disability and was devoured by a system that focuses on paperwork. Over time, his knees worsened, leading to a lack of mobility, weight gain, and diabetes. His doctor never explained to him the dire consequences of having diabetes. He passed away from a diabetic stroke, and he was my friend of more than half a century.
We all tried to help him, and I even went with him to his doctor and asked his physician to explain the danger that diabetes poses. All his doctor did was hand him some booklets on diabetes. Pete never knew how bad having diabetes is, and I believe to this day, it hastened an end to his life.
In looking at the curriculum to become a doctor for a couple of top medical schools in the US, I noticed that there needed to be more focus on doctor-patient relationships. That needs to change. Every medical student needs to have a thorough understanding of patient behaviors.
Our healthcare system focuses more on treating “conditions” than the person. The weight loss drugs which are being hyped are the perfect examples. They focus on losing weight by using a drug that suppresses the appetite. They don’t address the underlying causes of obesity, and most patients regain their weight once they stop taking the drug. Patients who are prescribed the medication for weight loss should be required to meet with a nutritionist.
Primary care doctors spend about 3.5 hours a week doing paperwork, compared to 2.1 hours for surgical specialists. Each doctor is backed up by clerical support staff, who do 7.2 hours of work per doctor daily. In an era where almost everything can be simplified online, our healthcare system is still in the past.
The other challenge is health insurance. Health insurance access barriers are a serious and growing problem affecting patient care. Focus group participants said they have seen patients’ health deteriorate due to insurers’ access barriers, such as step therapy and nonmedical switching, especially when patients live with chronic medical conditions. Health professionals cited two reasons for this deterioration—having to prescribe older, less effective drugs because insurers would not cover newer medications and being unable to refer patients to needed specialists.
Add it all up, and it means doctors are only able to spend a little bit of time with patients so they can understand barriers to treatments. I want to be seen as a person, not a patient, with something an Rx can cure. I did have one doctor who took the time to listen, but we moved away, and I never saw him again. Maybe one day this can be turned around.