What ever happened to American medicine?
How is it possible that a country once ranked number one in the world in healthcare has declined to a country that ranks last. This has happened within my lifetime, so I have been a front row observer of this sad process. I was once proud to be an American physician. That is no longer the case. American doctors are now known in foreign countries as entrepreneurs who wish to live large off their patients.
When we ranked number one in the world, 70 - 80% of the people received their care from family practitioners or G.P.s (general practitioners as we once called them). Now ranking last in the world, we receive 70 - 80% of our care from super specialists. How did this come about?
In the 50s and 60s the majority of care was given by family practitioners, you know, the kind of physician who knew everyone in the family by name and knew what Aunt Tillie and Uncle Art were doing and could converse about how the crops were doing and did your dog get over the problem it was having. Remember when your doctor used to sit on the side of your bed and take the time to talk and actually look into your eyes, hold your hand, and show a genuine concern for how you were doing, to ask what you think was going on, and were there problems we were not addressing.
I remember a time when I laid out on a grave with a family all night long when their son Ricky had returned from Vietnam the day before and had gotten killed in a car accident the very same day. I remember his three sisters standing out under our porch light ringing my doorbell to take me to the graveyard with them to try to console their mother. I remember patients showing up at my front door in the middle of the night to be seen or talk with me because my home was closer than the emergency department in town. I looked at these countless encounters as blessings.
These are the blessings today’s physicians go without. They do not know what it is like to take care of and actually have a connection with a patient. When was the last time you ran into one of your specialists in the supermarket and they addressed you by name? Quite a while ago, huh? Yes, those days are gone and with them went American medicine. It is more important now to have a larger pay check than practice satisfying medicine. Family practitioners today could, with a little training, take care of 90% of your problems with the specialist taking care of the remaining 10%, rather than trying to support themselves by doing family practice for which they are woefully unprepared.
I feel sorry for those physicians and the people of today who will never know what good, connected medical care is, those who never got to practice or receive care in the golden age of medicine, and the poor American citizen who receives care now and thinks this is the best the world has to offer. We are number one in the world in everything, aren’t we? Oh wait, I am thinking about 50 years in the past when we were number one and a country that led the world in nearly everything.
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