One of the largest problems in medicine in the U.S. today is super specialization. It is great to have a physician who knows so much about one little area of care. If that happens to be the area of expertise you need, it can be valuable to the point of lifesaving. Unfortunately the care becomes so fragmented that the overall care of the patient becomes quite poor.
This is somewhat evidenced by the fact that in spite of our new diagnostic modalities the status of healthcare in the United States has fallen to 37th in the world. This parallels what has happened to our country in education where we now rank 37th in the world in education. We now rank behind many of the third world countries in many measurements of health care. We rank behind Puerto Rico in longevity. We rank behind Cuba in infant mortality.
How does this happen? Not that many years ago when the U.S. ranked number one in the world in medical care the majority of care was provided by primary care physicians. One reason that primary care was so successful was that one physician cared for the whole person. It is impossible for a person to have several physicians care for them and expect great medical care. If the patient does not fall under the aegis of the physician caring for them they often have to pick out their own specialty. Often times the specialist we are seeing is not sure what specialty the patient should be referred to.
In the sixties it was considered unethical for another physician in your group to charge for a consultation. It was considered a way to pad patient charges. Now it is not considered out of the norm for a patient to see as many as ten different specialists within the same group. It surely helps out with the bottom line does it not? Why charge a patient once when you can charge them ten times? Why refill a maintenance medication for a year when you can have them return for a refill every month? Granted, a lot of these problems are not the problems of individual physicians. It is understandable that a neurologist does not want to prescribe a sleeping medication for their patient without first referring them to a sleep study clinic. How on earth did the US ever function without all the sleep study clinics and being able to put the patients by the thousands on C-PAP. This all comes about because it is a highly lucrative branch of medicine that incurs many charges without much expertise being needed. It is indeed now an industry. Now the government has passed a law that this is required for all commercial driver licensees. I am almost certain this is going to cut down on the cost of medical care just as the government is trying to do with just one more regulation crammed down the throat of the American public. If it is good for all commercial drivers why not make it compulsory for all drivers? After all there are more non-commercial drivers on the road than commercial ones.