Frustration. That’s the emotion I feel when I seek a certain solution to a simple medical problem. And instead I get referred from one doctor to another. It’s like you’re a basketball being passed from one player to another.
I, Dr. Farrah Aurora Agustin-Bunch, a general practitioner (GP) doctor turned holistic naturopathic doctor, am fed up with the situation of overspecialization in the medical and healthcare industry. I swear I will not do this while I’m the head of the Dr. Farrah Agustin-Bunch Natural Medical Center.
What is wrong with the current healthcare system?
Overuse of health care services seems to be the order of the day for most hospitals and specialty clinics. Each year, billions of dollars are spent on healthcare and medical services. Spent on services that could have been simplified and consolidated in just one doctor or specialist.
Why the need for specialization or the engagement of so many doctor specialists?
There is a host of reasons to explain this: lack of consensus among doctors about the diagnosis and which treatments are effective, a reluctance by patients and doctors to accept diagnostic uncertainty thereby leading to more tests; and the perpetuating belief that newer medical technology and more expensive drugs are better.
The most important reason is – the increasing frequency for general practitioner doctors to pass on
the examination and diagnosis of a patient to a specialist doctor.
This truth makes me utterly irritated. When I started practicing almost two decades ago, generalist doctors still held a very important part of the consultation process (they still do now). New patients were referred to the “first line of defense” who were us generalist doctors.
At that time, GP doctors were imbued with lots of information and experience in diagnosing newly arrived patients. Because they are the first line of defense of the hospital and the first ones to see the patient, they had to know quite a lot about the different medical specialties to be able to refer a patient to the right specialist. They could perform the simplest to rather complicated medical procedures in an emergency situation or even assist a woman in giving birth to her child when immediately called for.
When did we emasculate the GP doctor and made him/her into a mere receptionist at a large, well-
established medical hospital?
Taking the Humanity Out of the Medical Profession
Gone are those days when most medical doctors had a heart that cares. At that time, doctors still consider you as a “person” with fears and hopes of getting well, not as a mish- mash of parts to be looked at, prodded and inspected. And considered as a lucrative source of business.
A long time ago, medicine was much more uncomplicated. Medical doctors made it a point to know their patients better, to ask about their stories, get to know their families and their jobs, and made sure that their problem was understood, diagnosed correctly and given a “sound solution” wherein they don’t have to sometimes spend too much by giving them a slew of tests to find out what’s wrong with you.
The Overpopulation of Specialist Doctors
The past half-century witnessed great changes in American medicine. One of these pivotal changes is
the continuing increase of specialists. In 1940, a good 75% of U.S. physicians were general practitioners. By the 1960s to 2002, the general population of new physicians actually ballooned. At that time, about 25,000 new medical doctors went into practice annually with the physician population in the U.S., rising at a rate of 3% while America’s population increased by only 1% annually.
Because of the increase of doctors annually, there was a general trend to specialize, among other things. It is generally known now that specialist doctors command more money and benefits than generalist doctors. With the increase of the specialist doctors, there was also a phenomenal rise in medical expenses of professional fees, laboratory costs, etc. – from US$3 billion in 1940 to US$75 billion in 1970.
U.S. Doctors population
Currently, the U.S. has an overpopulation of doctors now, with 29 doctors per 10,000 people. This figure
is certainly higher than other countries like Canada, United Kingdom, New Zealand, and Japan wherein healthcare systems are much better than in the U.S. Other countries with worse healthcare systems, like Bulgaria, Azerbaijan, and Kazakhstan, have even higher physician concentrations than the U.S. As our physicians become more specialized, our health systems become, as a colleague in the industry said, “more sloppy, disorganized and costly”.
We cannot let this trend to continue. Being sloppy, disorganized and costly is definitely not what we signed up for as medical doctors in the first place. As the Hippocratic Oath says: “I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.”
Let us strive for a 70%-30% ration of general practitioner doctors to specialist doctors, respectively in our hospitals. Let us be well-versed with all the many aspects of the medical practice so we can fulfill our duties to be truly “the first line of defense” in any medical institution.
And most importantly, let us practice our profession with a heart, as true doctors are meant to be.
What about you – do you agree with our stand against overspecialization in the medical field? Share your ideas in the comments section below!