The following posts are personal opinion informed by decades of experience as an emergency physician. These statements have not been evaluated by the FDA, the CDC, or the IRS. It is, however, very likely they've been recorded by the CIA and NSA, because that's what they do.
Do I care, nope. It's just the world we live in.
Now, the next disclaimer arises from the need to clarify what this blog is about. When I first started, it was a place for me to mess around. No one read it and I didn't mind. Now, I'm getting traffic and I have to step up my game. So here it is. The first blog posts were fun but people want more information on what to do about healthcare so I'm putting some thought into it and start writing it down.
What's my mission?
Common sense solutions. That's it. Nothing crazy, no big conspiracy (although I love them), just a simple strategy to transform our experience of health and how we take care of ourselves and each other. One size fits one and since everything is medicine there's no need for a middle man.
What's my role?
I'm just a guide. I show the way. I combine old and new ideas to bring something useful to the fore. I demonstrate solutions to complex problems. I do this in the ER, I do it in the clinic and I do it at home anytime someone asks for my opinion. There may never be a single right answer, but there are many good ones.
My medical career has brought me full circle. I've been a doctor, a patient, an administrator, a superstar and persona non grata. I've worked in helicopters, ER's, ambulances, clinics, tertiary centers and small town hospitals. I've delivered babies in bathrooms, waiting room, back seats and OR's. I've treated more gunshots and heart attacks than I can count. All that is to say, I know a thing or two about where we've been and I have some pretty good ideas on where we're going.
Where are we going?
Right now it looks like we're going to hell in a hand-basket. And that's okay. Breakdowns always feel bad because we have to let go of old habits of thought, word and deed. It feels like we're losing something. There's grief. There's sadness. There's anger. Lots of anger, and that's normal. It only lasts long enough to get you to the breakthrough.
Ok, we're not going to hell, but where are we going?
Some people think we're on our way to a communist utopia. Others see a revolution of one kind or another. Many defend the status quo because why change something that's served so many, so well, for so long?
Me? I'm pushing for one on one accountability between doctors and patients. I'm pushing for individualized care and individual control over healthcare spending. I'm pushing direct primary care, individual coverage and medical cost sharing accounts. Imagine what would happen if your doctor was suddenly on the hook for getting paid directly by you? Would they treat you better? You bet. Doctors respond to incentives like anyone else. Align the incentives for them and they'll jump in line. It's all about the money. Buy what works and reject what doesn't. It will go away fast.
How do we get there?
Simple, we change how we pay. We cut out the middle man. Give the power and the money back to the people and let them decide how to spend it. At the same time, we put in place some common sense solutions to help people get through the rough spots. It's being done right now and it works. This isn't socialism, it's extreme conscientious individualism because how you treat one person is how you treat them all.
Thanks for reading.
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Matthew H. Evenhouse, MD is a board-certified Emergency Physician, published author, private pilot and international educator.