Modern Medicine? (Part 2)

This is the second of two articles looking into the difference between “modern” medicine and “wellness” medicine. This article will delve deeper into wellness medicine as well as address change that you the consumer can effect.

I wrote the last article while I was in Houston supporting our Air Force flying mission. Over the weekend I saw quite a few patients that were physically fit and only needed a quick physical and a signature releasing them for continued duty. I also saw a few that required more face to face time counseling them about areas where improvement was needed.

Military medicine, occupational medicine, and flight medicine differ from the core of “modern” medicine. While “modern” medicine focuses on treating illnesses, “wellness” medicine focuses on ensuring that patients are initially healthy and continue to stay healthy in order to perform often-hazardous tasks.

When I see patients who are overweight, I counsel them about weight loss. When I see a patient suffering from inadequate sleep, I counsel him on sleep hygiene long before I prescribe medication to help facilitate sleep. When I see a patient who smokes, I counsel her regarding smoking cessation. Both the military medicine and occupational medicine communities insist on counseling patients about careless habits and poor lifestyle decisions that put them at higher risk for heart attacks, strokes, and diabetes.

“Modern” medicine, instead, is concerned about patient-satisfaction scores and physician production goals. Physician visits are often concluded by office staff telling the patient that they will receive a survey regarding the care provided by the physician and office staff. Many large group and corporate medicine physicians are partially compensated according to their patient satisfaction scores.

The Archives of Internal Medicine posted the results of a survey of more than 50,000 patients in March of 2012. Interestingly, higher patient satisfaction scores were associated with greater inpatient hospitalization, greater total expenditures, greater drug-related expenditures, and higher mortality. Higher mortality? Doesn’t that mean death? Yes! Patients that were the “most satisfied” with their medical care DIED sooner after spending more on their healthcare.

WOW! Maybe those hard truths that no one wants to hear are actually not only “good medicine” but can be lifesaving. Doctors shouldn’t get paid to tell patients what they want to hear. They should get paid to reduce disease risk, help you get well, and keep you that way.

What to do with the surveys? Don’t throw them away! Put the blank survey in the envelope and mail it back to the survey company. It’s a lose/lose situation for the company contracted to do the survey. Either they report to the hospital organization that their survey was ineffective or they swallow the cost of processing the blank surveys. It’s a win for the patient and their doctor and cuts one of the many middlemen out of your healthcare. In a system whose only hope for financial solvency is increased efficiency, this would be a good start.

When you do see a doctor that counsels you appropriately about risk reduction, tells you that you don’t need the medication you are asking for, or doesn’t order the unnecessary test you requested, realize that they aren’t judging you or doing it to be mean, they are working to save your life.

Final note… Need a doc who has made (ahem) some of those same poor decisions and lived to tell about it? Stop by and see me. None of my soapboxes are too high, I’ve been there.

Disclaimer: Dr Stephen Rath, MD, DABA is a board certified anesthesiologist as well as the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. As before, the opinions given above are not necessarily endorsed by the U.S. Air Force, Lincoln County Medical Center, or even his wife. Comments or questions? His email address is: