Mythical and modern medicine (continued) 3/1/2021 5:15:18 AM
continue blog Medicine used to be practiced by physicians who lived in the community and were part of it as respected citizens. They understood the community and practiced accordingly. Who to charge whom not to charge, how much to charge, was at their discretion. Doctors were no more wealthy than any other professional in the community Gradually the concept of health insurance crept up and doctors started to get paid for some of their services without having to consider non-payment or partial payment of their fees. Income could be anticipated and was welcome. I would compare it to the first few puffs or a cigarette or two of "weed. This changed to more of the income being 'guaranteed' as the number of insurance companies increased. That income became a 'habit' as it felt 'good'. As the income increased. By the mid-fifty's and sixty's of the last century the doctors became affluent. Medicine became a little detached from the doctor -patient relationship. If you fudged a little you weren't cheating your patient, it was coming from a company. So the vicious cycle of dependence and distancing from the patient started. Some specialties in medicine got paid more than others so doctors started to gravitate more to them. The word 'specialist' acquired an aura among patients and arrogance among 'specialists' to the detriment and lowering of the esteem of the family physician who became a G.P.- somehow lower than the specialist. This started a slow decline of Medicine. The familiar physician who was available 24-7 and came to the house to see sick persons started to become a rarity. Patients went to the burgeoning Hospital emergency rooms. The 'burden' of a very sick patient could now be transferred to a specialist or the hospital. The cost of this was borne by Insurance companies who upped the premiums which were now more and more paid by employers. There were many middle men between the physician and patient now and the directness of service and the person to person contact became more indirect and more remote. Just a few years before this, as mentioned earlier, a physician could feel an empathy with the patients, knew them , felt for them and could tailor his fees. No more. (will continue)
