Intro to: Beware of the Medical Industrial Complex

A number of years ago I coined the phrase "Beware of the Medical Industrial Complex" as a regular posting member of the AC (Amazing Charts) User Board. You see I am the practice manager of a small, IMP (Ideal Medical Practices) style Family Practice. The practice is my wife's
and she is a very interesting character and pretty darn decent doctor if I must say so myself. I brag about how smart she is but many times she doesn't buy into it nearly as much as I do. Heck, I married her, was Mr. Mom for a good number of years so we could start a family while she finished Med School and then do all of her Residency Training. And then while she was busy commuting and working at her first real post training job, while caring for our two little ones at the time, I started her practice out of our living room while changing diapers and the like. As the saying goes, "I liked it so much, I bought the company!!!".

Anyway, my wife and I have been exposed to so many interesting, sometimes exciting while others truly upsetting or concerning things since she entered this business, that for a long time now I have felt a real NEED to speak the truth, inform and clarify what really goes on in this way out of control business. At the present time we are all hearing about the "Need" to reform this or Cut that and on the surface it sounds correct. But the view that the majority of Average well meaning Americans get is so distorted if not outright Wrong, at times even all too Intentionally misleading that there finally needs to be some "Sunshine" on what is happening inside this industry.

My basic premise is one that you might expect; and that is that the large money players in this industry, Including our Own Government (itself a really Huge Insurance Carrier via Medicare and the like) are at the heart of the horrible distortions and the complete lack of balance and ability to plan or act rationally. Almost all choices have been lobbied for or influenced by those with large financial stakes and horses in the race. Today the newest phrase that just makes my skin crawl is the one that came to the forefront during healthcare reform (which is really wasn't, but we'll get to some of that later) and that is the word, the phrase; "Stakeholders". 

All the converstions and all the policy debate kept coming back to this phrase this concept of Stakeholders..... But what exactly is a freakin' Stakeholder in the first place??? A stakeholder is a euthaism, a laundry mat cleaning term for all of the people who presently have a strong financial stake and horses in the race, mainly the worst of the "Piggies" feeding at the trough that is being consumed faster than we can find a way to fill it up!!! This includes the likes of super large corporations like any of the ones you can name in Big Pharma like Pfizer, AZ, Glaxo just to name a few off the top of my head, the absolutely "Heartless" insurance carriers for whom healthcare is never really about what is in the best interest of any individual patient no less what might be best for all of us as a society as a whole. Then there are newer Piggies fighting for a piece of the action such as the majority of EMR, EHR software vendors all trying to get their grimmy paws on our healthcare and tax dollars, medical device makers be it for equipment doctors use to provide care or perform procedures from exam tables and scopes to fancy laser devices that too many docs have went towards because only cosmetic procedures for the most part fall outside of the traditional insurance based system and are instead Cash on the Barrel, Pay in Full at Time of Service, what some refer to as PIFATOS.....

Now clearly some of this stuff is all too needed and yes it costs money to develop them, supply chain them and get them into the hands of doctors and patients at the time and place they are needed too. BUT, when was the last time a large Pharma Company went belly up, completely broke from doing what the gov't and many people over impose and expect out of doctors, even struggling and on the verge of going out of business primary care docs, and that is to provide goods and or services at a LOSS simply because it is in the interest of the greater good supposedly??? Yeah, right like that would ever happen.... In the words of Pink Floyd, these guys are "So Happy they can hardly Count". But as I just said, there is the underlying set of assumptions and misconceptions the doctors are all filthy rich and greedy bastards and for the most part nothing could be further from the truth, especially as one discusses primary care doctors. I have some frightening stories and stats to share with you my potential audience that will assist you if you care to turn prematurally gray and have trouble sleeping at night.

Anyway, it is so very late that now it is actually early and like most people I have things to do and work to get to sooner than I would like at this late, early hour. The kids are off for the week on Easter Spring Break so I have to deal with that and I have to get into the office to see what meger scraps the insurance carriers may or may not have returned our way for my wife's hard and dedicated work that lately doesn't even really meet operating expenses, cover our business and medical school debts, no less perhaps actually pay my wife and I an actual living wage... Don't even begin to allow yourself to think that there is any chance that we have been able to save a single Dime for a rainy day, our retirement no less our children's future...

One day soon I will post a few pictures if I can of my "Daily Driver" of a 13 year old Jeep Grand Cherokee with 208,000 miles on it, no front bumper, what little is left of the rear is hanging on by wire ties pretty much, a mismatched front driver's side door (Metal Fatiuge not a side swipe accident) and just about NO Rocker panels left as the winters and brine of the salt on the roads in Lake Effect Snow land has eaten them all up some time ago. A true classic "Winter Rat", beater or ruster, that runs like a top and refuses not to wake up in the morning and run.... Gotta love old Mamma Mopar and that super Dependable 318, 5.2 Magnum motor with Torqueflite tranny... But that my friends is the real and honest daily driver of a small businessman who is in business with his wife in persuit of her honest hardworking, all too needed and in demand people helping profession of primary care medicine today. And we are NOT the only ones either. I promise to explain how and why but right now if I don't go upstairs and get some shut eye I'm going to passout right here at the Keyboard. So let me crawl upstairs now while I still can....

Thanks for reading and following and I will do my level best to keep you informed and entertained hopefully at the same time. Please feel free to ask good and interesting, intelligent questions you might have about this business and if it is something I have knowledge of I will try to answer it for you or perhaps even go find out myself and get back to you on it. And if you have good solid data and research, articles from honest and legit sources that actually use scientific method and or double triple checking like professional journalism standards for sourcing their stuff and feel like sharing, that too would be great. I do not claim to have all the information, no less all of the answers but perhaps, just perhaps with the cleansing light of some serious sunshine, together we can figure a few things out, and start to build a real and honest consensous on how to better solve some of these seemingly insurmountable problems that lay ahead...

Have a great day and I hope to be hearing from some of you soon and enjoying that healthy formum of exchange and debate... But I am the moderator so understand in the end it is my Blog here and I do have the final say around here.... Later!!!

"The Ref"