The slow decline of the physical

I was listening to NPR about the slow decline of the physical exam at the doctor’s office. Apparently this tendency for doctors to actually physically examine their patients less and less is due to a couple of factors. First, doctors have become enamored with machines and technology, to the point where they seem to not even care what the patient looks or feels like, but to focus almost entirely on what the machine says. I suppose this is all very scientific and clinical, but I think that it is definitely losing some of the art of science. Simply looking at and feeling patients, is simply common sense in diagnosing medical problems. I believe doctors also love machines, because they can charge a lot more for them. If a doctor listens to a patient’s heart with a stethoscope, during a routine doctor’s visit, there is no extra charge. But, if the patient is wheeled off to an MRI, or in EKG, then both the doctor and the hospital are able to bill the patient a lot more money, and they themselves also make a lot more money; usually hundreds of dollars more minimum per procedure.

Another reason why doctors are cutting down on the routine physical is because they say that with only 10 or 15 minutes allotted for patient, that there simply is not enough time to give an actual physical. While this may be true, we should be asking ourselves why doctors are not scheduling themselves sufficient time to adequately do their jobs. After all, we are paying skyhigh prices for these visits, and getting into medical school is so difficult and so long, because presumably being a doctor is so important that only the smartest and most dedicated are fit for such an important job. And yet, after all that, doctors and the system undercut all those marvelous qualifications with a visit that is so short that everything is done half assed.

Frankly if medical care is important, the doctor should take as long as is necessary to adequately treat their patients, without cutting corners, which is what they are currently doing. And, if it takes an hour or more, to get to the bottom of what’s going on, then so be it, and doctors should prepare for such eventualities. When I went years ago to a homeopathic doctor in Brazil, she took a full hour to diagnose me during my visit, in my case was not a typical.

The reason why medical care is suffering due to doctors cramming too many appointments too close together is due to one main reason. The government has decided to grant the private unaccountable guild monopoly — the American Medical Association — with exclusive control over how doctors are trained. Naturally the AMA works in the interests of its members (senior doctors), and not in the interests of the American public. So, the AMA puts a quota on the number of people who can study medicine, so as to keep the supply of doctors artificially tight, thus reducing competition, and keeping demand and prices nice and high. With not enough doctors to go around, doctors may feel pressured to fit more and more patients into their schedule to meet demand. And, besides, it’s in their interest to do so, since more patients with less time spent per patient means more money. Why spend half an hour — or God forbid an hour — on a patient, when they can get by with 10 or 15 minutes, and still charge the same. And, if patients don’t like it, they have nowhere else to go, because there is a shortage of doctors. The government does nothing to change the situation, because they are bought off by the AMA. And the same is true with the media, which keeps absolutely silent as well on this scandal. Furthermore, the system actually works to suppress alternative medical treatments, which could provide competition to the AMA´s monopoly.

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