By Larry Marsh, Kansas City Star Midwest Voices columnist
Should Congress pass a law requiring everyone to see a doctor at least once a year? Would such a law decrease or increase disease and preventable deaths? The answer may be more complicated than you think.
Doctors are busy people. They have to be because our fee-for-service system means they have no salary and only get paid by the number and nature of the patient visits and procedures they are responsible for. The no patients means no money part makes sense. But what about the lots of patients means lots of money part of the equation? What if some patients are really sick and can't get their doctor's attention because they are in and out in 10 minutes?
What happens in the typical check-up visit? The nurse records your weight and height and takes your blood pressure. The doctor places a stethoscope on your chest and back, has you breath deeply and then asks if you have any unusual pains or discomfort. That's nice, but my height hasn't changed much in 40 years. I record my weight every day at home, and every pharmacy in town has a blood pressure testing device ( not to mention the $15 one I use at home ). As to my lungs, I have almost 65 years of experience listening to my body talk so I know right away when my lungs aren't performing up to par.
Have you discovered that your doctor didn't have time to review your test results before seeing you or doesn't get to all the items on the list of reasons for seeing him or her that day? The problem is called Taylorism. It is an inherent part of capitalism and the industrial revolution. It is as American as apple pie.
Taylorism refers to the ideas of industrial engineer Frederick W. Taylor in his 1911 book "Principles Of Scientific Management." Basically Taylor emphasized the importance of assembly line efficiency to maximize profits. Time is money. On an assembly line maximum productivity is essential. The quicker an item can be processed the fewer labor hours are required resulting in more items processed per day and higher daily profits.
To some extent voluntary methods to speed up the medical production line have been successful. Allowing the pharmaceutical companies to advertise on television was a brilliant move for bringing in more patients. It was clearly a win-win deal for both the drug companies and the doctors.
A friend of mine asked me the other day how I was paying for all my meds. To his surprise I said "What meds?" Could a man approaching 65 years of age actually be drug free? After all, those nice people my age on television are all on drugs so why not me? Since these are mainly prescription drugs seeing a doctor is the only legitimate way to get the drugs. Of course, renewing your prescription will require some more medical tests. As long as the drugs don't actually cure you, but just manage your real or imaginary condition, this medical version of Taylorism works great.
But, alas, Taylorism is not satisfied with business as usual. Labor productivity must be continually enhanced. This means speeding up the production line some more. In medical terms this means processing more patients with more drugs, tests and procedures more quickly.
In all fairness to doctors I should mention that the exorbitant money sometimes awarded in malpractice lawsuits motivates doctors to order testing and drugs at the drop of a hat. If a patient mentions a drug they might need (one they presumably heard about on television) doctors feel pressured to prescribe it just to avoid the possibility that failure to do so will set the stage for a nasty lawsuit if the corresponding disease or illness develops.
What this all boils down to is a very sick system. Patients who need lots of attention just slow things down. Unless they have lots of their own money or lots of insurance money they aren't going to get all the help that they need. The system is just not designed to focus on the few patients who really need a lot of attention. Unless doctors are put on salaries and a cap is put on malpractice awards, we're not going to see any improvement any time soon.
Perhaps there are some intelligent prevention measures that insurance companies should require in order to reduce your premiums -- like a colonoscopy at least once every 5 or 10 years.
Having Congress require annual doctor visits doesn't necessarily make sense if the goal is to reduce the overall incidence of disease and preventable death. Let those who really need to see a doctor get all the time and attention they require. The rest of us can decide for ourselves as to whether we need help checking our height, weight, blood pressure and lungs on an annual basis.
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Also see:
We need to move beyond a one-size-fits-all health care system
To some libertarians even private health insurance is a bad idea
The incentive structure of our health care system is all wrong
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For more Larry Marsh commentary go to Twitter or go to Google News and search for "Larry Marsh Kansas City Star".
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Jenniferm -
Don't worry about the car with the tailpipe dragging the ground. It won't cause you any harm. Worry about the guy driving it texting on his phone.
Yes....
...this is an excellent idea since the state of Missouri makes me get my car inspected every two years I know exactly what I need to do in order to make my car safe for myself and others.
But why do I see such junk on the road and how do they get their inspections approved?
People who claim
that they cannot afford an annual physical generally manage to spend that amount of money on any number of other things, many of which are totally frivilious. Just like my co-worker who whines about the $25 co-pay and claims she 'can't afford it', but spends about $300 at the salon every month, eats out all three meals just about every day, and just got a brand new I-phone with unlimited everything service. Most people who claim they can't afford it, CAN. They just prefer to spend the money elsewhere and want taxpayers to pay it for them.
I can't
Just buried a relative who had gone years without a health check-up...she thought she was a "healthy" person--that's until her cancer exploded.
I have to pay out of pocket. My insurance doesn't cover preventive check-ups!
I wonder why we are sending our kids to war or call ourselves a christian nation. We are refusing to adhere to the main principles of both, keep our country "safe" and live by the principles practiced by Chris. His time on earth was primary spent carrying for the hungry and sick, not protecting the interest of the griddy and wealthy. when are we going to start living by the principles we often preach? Let's not confuse party affiliation with our moral duty!
kenm....
we need it because the fascists love to tell people what to do. It provides the fascists not only employment, but also a sense of superiority.
almost less then 13 months of this insanity...
George Orwell had the year wrong
..
Why do we need a government
Why do we need a government to tell us when we need to go see a doctor. What part of the constitution requires or penalizes us for not seeking yearly medical attention.
Health care is an individual choice, lets keep it that way.
A regular check up is needed.
Depends doesn't it, if you check you own blood pressure,temperature, get out and exercise regularly, then you probably know what is normal for yourself and when you should go to the doctor. You should know how to take care of yourself for most simple things, but some things are pretty insidious, can sneak up on you. That's why a regular check up is needed.
Gasp!
You have got to be SM!! The folks actually have the sense to see a doctor if needed, and the government does not have to make them.....imagine that!