NeuroNews

Healthcare Wellness or Widgets?

  

 delicious  

  

The Oct 13 issue of the New England Journal of Medicine contains two seminal and antipodal articles on healthcare.  The tension between these two articles embodies the controversies of three decades of debate over how healthcare should be delivered. 
The first article, “Rethinking Health Care Labor,” by Kocher and Sahni, compare real sector growth, labor productivity growth, and employment growth of various sectors, and not surprisingly finds that manufacturing has outpaced the other sectors from 1990-2010.  Its employment growth, however, is far less than other sectors.  The authors bemoan the fact that healthcare cannot be favorably compared to manufacturing.   Alternatives that fail to address this lack of increased labor productivity in healthcare “will inevitably lead to a future in which health care salaries come under extreme pressure, as payers and policymakers resort to traditional levers of market-basket cuts and utilization controls.”
The second article, "The New Language of Medicine," by Hartzband and Groopman,  argue that a new language has been created to depersonalize the practice of medicine, the prevention of disease, and the healing of human beings whose lives have been, or can be, shattered by illness.  Patients become “consumers” and “customers.”  Doctors, nurses, and allied personnel become “providers,” lumped into one category for business purposes with no assumption of professionalism or art.
I believe the tension in these two approaches can be resolved easily as long as patients are allowed to decide their fate.  Patients are not stupid.  Give them a choice, and they will decide for themselves whether they want to be people or widgets.  

For the record: at MidAmerica Neuroscience Institute, we don't make widgets, we take care of people.