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    February 19, 2021
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Business Insight Doctor-Patient Relationship It became almost a cliché to hear about the doctor-patient relationship. Hospitals talk about it. Advertisings of medical services talks about it. It sounds well so everybody uses it. But not everybody means it. Like any other relationship, doctor-to-patient one should be and must be based on knowing each other. Doctors knowing their patients means remembering their medical histories, family histories, understanding their life circumstances. It is pointless for a doctor to see a patient and writing a prescription for a drug that will cost more than a monthly income of a senior. It is also pointless to prescribe a 3-times a day ointment to a truck driver who spends weeks in his truck. If you attend the same doctor for several years for the same chronic condition that relationship becomes a norm so if you need a telephone assistance, more than likely your doctor will remember you and will know what to advise you. And with electronic access to records, she or he will be able to instantly check your prescription. What I am describing is more than likely non-existent. 75% of doctors' work in large left behind and patients nowhere in sight. groups, hospital based medical groups or private equity owners and they do not really see 'their' patients. They see some patients. It is not uncommon for a person to attend one and the same medical group and see a different doctor every time. Often, these random visits do not relate to the previous histories and each visit is a separate encounter, often conflicting what was done before. I had a research patient once who was a part of a large PCP group in Wisconsin and has seen 13 different providers over 24 months treating his sore throat in at least 8 different ways, making diagnosis of current medical issues. American healthcare antibiotics resistance, chronic pharyngitis, system spends the most per capita than any asthma, with nobody testing anything and prescribing more and more drugs only to come up with an ending conclusion of severe gastric reflux. I am not at the position to teach doctors how to be doctors. But I can take a position of exposing a huge failure of our extremely costly healthcare system, in which we get sub-optimal care despite paying thousands of dollars in premiums only due the center of attention of the system is profit rather than doctor-patient relationship. That profit goes to the pockets of administration of relationship? Or perhaps it is time to go to the a huge machine of the system, most of which is dysfunctional and has nothing to do with health. If you add the insurance system to this picture, you end up following the rules developed by administrators for administrators, with doctors Medicare spends about 94% of its budget to pay the doctors and hospitals. Only 6% of Medicare operational cost is an overhead. The problem is that, with 65+ population, Medicare covers the sickest and the poorest. In private insurance industry, over 2596 of budget money goes to the operations, including millions of dollars in bonuses for the top executives. Many of these executives have MD behind their name but have not practiced medicine for many years. Not only do they not see patients, they would not be able to even address the other system in the world. Yet, we have the most uninsured patients in all civilized countries, and our life expectancy is shorter than most. Further, more and more doctors are tempted by large groups to give up their practices and sell to the administrative entities. What is in it for the patients? Instead of a doctor-patient relationship, you will have a relationship with a medical group call center. You will be lucky if you hear back from any provider after 2-3 days. Is it time to demand new definition of the doctor-patient fact that a old-fashioned way of practicing medicine, with a doctor's bag at your side? Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net Business Insight Doctor-Patient Relationship It became almost a cliché to hear about the doctor-patient relationship. Hospitals talk about it. Advertisings of medical services talks about it. It sounds well so everybody uses it. But not everybody means it. Like any other relationship, doctor-to-patient one should be and must be based on knowing each other. Doctors knowing their patients means remembering their medical histories, family histories, understanding their life circumstances. It is pointless for a doctor to see a patient and writing a prescription for a drug that will cost more than a monthly income of a senior. It is also pointless to prescribe a 3-times a day ointment to a truck driver who spends weeks in his truck. If you attend the same doctor for several years for the same chronic condition that relationship becomes a norm so if you need a telephone assistance, more than likely your doctor will remember you and will know what to advise you. And with electronic access to records, she or he will be able to instantly check your prescription. What I am describing is more than likely non-existent. 75% of doctors' work in large left behind and patients nowhere in sight. groups, hospital based medical groups or private equity owners and they do not really see 'their' patients. They see some patients. It is not uncommon for a person to attend one and the same medical group and see a different doctor every time. Often, these random visits do not relate to the previous histories and each visit is a separate encounter, often conflicting what was done before. I had a research patient once who was a part of a large PCP group in Wisconsin and has seen 13 different providers over 24 months treating his sore throat in at least 8 different ways, making diagnosis of current medical issues. American healthcare antibiotics resistance, chronic pharyngitis, system spends the most per capita than any asthma, with nobody testing anything and prescribing more and more drugs only to come up with an ending conclusion of severe gastric reflux. I am not at the position to teach doctors how to be doctors. But I can take a position of exposing a huge failure of our extremely costly healthcare system, in which we get sub-optimal care despite paying thousands of dollars in premiums only due the center of attention of the system is profit rather than doctor-patient relationship. That profit goes to the pockets of administration of relationship? Or perhaps it is time to go to the a huge machine of the system, most of which is dysfunctional and has nothing to do with health. If you add the insurance system to this picture, you end up following the rules developed by administrators for administrators, with doctors Medicare spends about 94% of its budget to pay the doctors and hospitals. Only 6% of Medicare operational cost is an overhead. The problem is that, with 65+ population, Medicare covers the sickest and the poorest. In private insurance industry, over 2596 of budget money goes to the operations, including millions of dollars in bonuses for the top executives. Many of these executives have MD behind their name but have not practiced medicine for many years. Not only do they not see patients, they would not be able to even address the other system in the world. Yet, we have the most uninsured patients in all civilized countries, and our life expectancy is shorter than most. Further, more and more doctors are tempted by large groups to give up their practices and sell to the administrative entities. What is in it for the patients? Instead of a doctor-patient relationship, you will have a relationship with a medical group call center. You will be lucky if you hear back from any provider after 2-3 days. Is it time to demand new definition of the doctor-patient fact that a old-fashioned way of practicing medicine, with a doctor's bag at your side? Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net