Saturday, March 11, 2006

It's Not About the Money

There has been some discussion lately about the economics and business of Medicine and some of the ethical & moral issues surrounding this. Oftentimes, these issues get lost in all the rhetoric.

In my POV, I don't think the debate is over whether doctors should make a lot of money from their profession. I don't begrudge highly skilled surgeons and well-respected, knowledgeable physicians earning large amounts of money for services rendered in practising good solid Medicine. Many have & still do make a lot of money for much needed services mostly in the private sector, to cater to people who can afford it (hopefully!).

I think most of us in the medical community have no qualms about denouncing the doctors who prescribe addictive drugs like benzodiazapines or Subutex or codeine-containing cough mixtures inappropriately. This is clear-cut inethical behaviour.

However, when doctors start to perform aesthetic procedures on teenagers, prescribe weight loss medicine to non-obese patients, or order a gamut of largely unneccessary tests under the auspices of Health Screening, I start to wonder at the motives of these "healers". I don't feel comfortable with doctors pandering to the vanity of the masses, the way they do now, with the numerous ads one sees in various publications expounding the availability of aesthetic services. They have become glorified beauticians. The LASIK procedure is also being aggressively promoted (not as bad as in the US but still...), and now that the competition is heating up, I wonder about the decision making process both for the doctors (in patient selection) and for the patients (same day service - eye assessment + procedure done on the same day...does that leave time for the patient to actually go home and think through this???).

It is all these gray areas which we should question ourselves about.


Dr Oz bloke said...

The tide has turned some time ago.

Like a Tsunami it is difficult, if not impossible to stand up to.

I believe that at the end of the day every one of us doctors has a choice on what to do. Stand our ground and face the coming tide? Run for our lives? Go with the tide and let it take us wherever it wants?

Regardless of the options we choose, some will survive, some will die, some will die horribly.

The real reason why we are where we are today, is because we broke ranks many eons ago. Doctors became individuals rather than a collective body. I wonder how things would be had we been like a throng of thousands hands together choosing to face the coming storm. Perhaps we would have put up a much more effective resistance then.

The catch phrase of the 80s, 90s and now 00s is "To each his own"

It is time we abolished the SMC then.

Ang Yee, Gary said...

With polyclinics prviding subsidized medical care.

With NTUC Managed Heath care undercutting most GP, can u blame those GP from trying to make a living?

NTUC Healthcare has unveiled its new concept in healthcare.
It is offering a wider range of services -- medical and dental services, and traditional Chinese medicine -- at one location.
It has also announced a new pricing structure for its Medicare Clinic services.
Consultation fees are now a flat S$12, with medication at S$2.10 per course of medicine per week.
NTUC Healthcare says it aims for greater transparency with this flat fee structure.
The Toa Payoh clinic is the tenth in the network and the plan is to build NTUC Medicare into a group practice of up to 30 clinics covering the major heartland areas island-wide. - CNA /ct