Business Insight presented by Arlington Dermatology Too Big To Fail? What is the most important thing in healthcare? My answer is simple: access and privacy. Nobody likes discussing their most intimate issues openly. We like it when we get recognized by our doctors and nurses. We love attending to the same doctors for many years, knowing they have our medical and family history and can see us as a person. This is exactly what is NOT happening these days. Consolidation and acquisition are the most frequent activities in healthcare. To make it worse, the players in these activities know nothing about medicine. They are usually big financial companies, private equities, or management companies. They buy out hospitals and private practices, growing them to enormous sizes, mostly in search of higher profit. That expected profit in no way goes to doctors or nurses; it is going to the pockets of 'shareholders/ investors. In other words, there are many financial institutions who want to get richer from exploiting human misfortune of people getting sick. Of course, many will say, yes, this is how capitalism works, but I do not need re-education about that. It is a different story if financial people get richer selling more iPhones or trendy shoes. When it comes to healthcare, you need to question how ethical it is. In healthcare, patients are the number one priority, have always been as they should be. The quality of care we deliver is not limited to doctors, but extends to nurses, medical supplies, medications, technicians, and everyone and everything directly or indirectly serving patients. There is no question about it, and nobody can deny it. Unfortunately, in those large, consolidated practices and hospitals, the main priority gets fogged. There is so much stress and tension associated with administration, shortages, and just simply daily operations that patients become a nuisance rather than a priority. Yes, they are welcome to come, but how they are served is a secondary issue. Calls from patients are received by call centers in a different state, bills are delegated to yet another department in another state, refills wait for days to be looked at, and scheduling an appointment requires months of waiting. Recently, I had a patient who developed a cardiac condition, severe enough for us to be unable to take his blood pressure. We do not treat cardiac diseases. We tried getting him to see a cardiologist, but the closest appointment was in November. Well, he needs to be evaluated and get a new prescription much sooner. Is the emergency room visit the only way to get it? Isn't it how we make our healthcare costs higher? I tried getting to the bottom of the problem, but I could not get anybody on the phone to talk to me about it. And I am a referring doctor. Try to imagine if I made my patient handle it himself! Many of the doctors I talk to at various continuing medicine conferences tell me the same: they are not happy not to be independent. Their autonomy for making decisions has been taken away and, with that, quality of care disappeared as a priority. Often, they have to deal with patients who, as a result of these changes, cannot pay the bills or buy prescriptions. Many services they used to deliver years ago are now 'outpatient' institution services, with charges 10 times higher. And what is troubling, we have already gone through processes similar to that. In the 1990's, it was a very similar trend of consolidating some practices and it all ended not so well, with many dissolving and punished for non-compliance. So why can't we learn a lesson? Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net Business Insight presented by Arlington Dermatology Too Big To Fail ? What is the most important thing in healthcare ? My answer is simple : access and privacy . Nobody likes discussing their most intimate issues openly . We like it when we get recognized by our doctors and nurses . We love attending to the same doctors for many years , knowing they have our medical and family history and can see us as a person . This is exactly what is NOT happening these days . Consolidation and acquisition are the most frequent activities in healthcare . To make it worse , the players in these activities know nothing about medicine . They are usually big financial companies , private equities , or management companies . They buy out hospitals and private practices , growing them to enormous sizes , mostly in search of higher profit . That expected profit in no way goes to doctors or nurses ; it is going to the pockets of ' shareholders / investors . In other words , there are many financial institutions who want to get richer from exploiting human misfortune of people getting sick . Of course , many will say , yes , this is how capitalism works , but I do not need re - education about that . It is a different story if financial people get richer selling more iPhones or trendy shoes . When it comes to healthcare , you need to question how ethical it is . In healthcare , patients are the number one priority , have always been as they should be . The quality of care we deliver is not limited to doctors , but extends to nurses , medical supplies , medications , technicians , and everyone and everything directly or indirectly serving patients . There is no question about it , and nobody can deny it . Unfortunately , in those large , consolidated practices and hospitals , the main priority gets fogged . There is so much stress and tension associated with administration , shortages , and just simply daily operations that patients become a nuisance rather than a priority . Yes , they are welcome to come , but how they are served is a secondary issue . Calls from patients are received by call centers in a different state , bills are delegated to yet another department in another state , refills wait for days to be looked at , and scheduling an appointment requires months of waiting . Recently , I had a patient who developed a cardiac condition , severe enough for us to be unable to take his blood pressure . We do not treat cardiac diseases . We tried getting him to see a cardiologist , but the closest appointment was in November . Well , he needs to be evaluated and get a new prescription much sooner . Is the emergency room visit the only way to get it ? Isn't it how we make our healthcare costs higher ? I tried getting to the bottom of the problem , but I could not get anybody on the phone to talk to me about it . And I am a referring doctor . Try to imagine if I made my patient handle it himself ! Many of the doctors I talk to at various continuing medicine conferences tell me the same : they are not happy not to be independent . Their autonomy for making decisions has been taken away and , with that , quality of care disappeared as a priority . Often , they have to deal with patients who , as a result of these changes , cannot pay the bills or buy prescriptions . Many services they used to deliver years ago are now ' outpatient ' institution services , with charges 10 times higher . And what is troubling , we have already gone through processes similar to that . In the 1990's , it was a very similar trend of consolidating some practices and it all ended not so well , with many dissolving and punished for non - compliance . So why can't we learn a lesson ? Michael Bukhalo , MD Arlington Dermatology 5301 Keystone Court Rolling Meadows , IL 60008 Tel . 847 392 5440 | www.arlingtondermatology.net