Wednesday, May 16, 2007

The Ineluctable Division of Labor

In health care, what formerly was a 'medical practice', i.e., a doctor seeing patients, keeping patient records, prescribing, and treating, has become a money-making machine overseen by a doctor.

Every part of the process has been parcelled out to a specialist, and in many cases these 'specialists', far from performing any useful (to the patient) task, simply act as gatekeepers and attendant priests of the temple. The receptionist grandly positions you in the waiting room, and in the assembly line that keeps the 'nurse' and the 'doctor' busy. The 'nurse' ostentatiously takes your temperature and blood pressure, as though something new would be revealed and then reveals their total ignorance of who you are or why you're there by asking you for your past medical history, and misspelling the names of the drugs you're taking.

The doctor is the most likely of this motley crew to actually be who they say they are, or have some idea of what's going on. But don't bet on it.

It's simply not about medicine any more. It starts with the doctor's desire to pay for med school and have a good job, and quickly becomes a small industry, a way to make money that masquerades as a doctor's office. And we wonder why we can't afford it.

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