Posted by: AtlasMD

October 7, 2013

Hold On To Your Highbrow Hats: Rand, Rock, Greek Gods and Direct Care…

We came across an academic paper highlighting attention paid to Rand in the works of contemporary scholars and intellectuals. Prog Rock (especially Rush songs penned by Neil Peart, drummer extraordinaire), Greek Gods (Dionysus and Apollo specifically), and Randian libertarianism intersect in this curious research from NYU.

It might seem off topic, but this paper stirred up thought on our end — how do we rectify a healthcare system comprised of people? Yes, people — doctors, patients, providers, pharmacists, politicians, insurance agents, the whole lot of parties all wrapped up in one complex machination. Given that we know most problems are people oriented, and that our industry ensures the health and longevity of people, it seems like we’re in for a perpetual rollercoaster ride. On one hand, we consistently talk data and numbers, especially money, and how bureaucracy misallocates it. This is a more Apollonian argument, one based in reason and logic. We support direct care because we want services to be rendered more efficiently. It’s easier to pay us $600 for a year’s worth of unlimited service than it is for people to pay an insurance agent for a premium with copays and deductibles so that they can find a doctor within their network who will hand their insurance information over to a third party biller who will go back to the original insurance company to request a payment in part that will then go back to the provider who also has to bill the patient for a copay that varies depending on their deductible…

Pardon us, that was getting a little out of hand, but that’s what’s happening for many people. Perhaps it’s a little easier for employees who receive insurance through their employers, but even then you add more complexity — lawyers and advisors who help large companies insure their workers, which gets added to that convoluted process described above. Now the Apollonian part of our brain says that primary care (and other one off procedures like gall bladder removal, lasik surgery, and more) will benefit from a cash-only transaction. Insurance is a necessary evil, but its pitfall is the entropic nature of the money flow. Patients pay into a plan, then opt in for treatment, then the provider has to circle back to the plan in order to determine a copay/deductible, then patient billing occurs and then insurance billing occurs. This is inefficient, and as anyone with a loose understanding of physics knows, terribly inefficient, with each transaction acting as friction slowing down our moving object (let’s imagine that as rendered services).

But when man is purely rational, according to the Randian-inspired song “Hemispheres” by Rush, then he is like one hemisphere, and he is lacking the passion of his Dionysian nature (the other hemipshere). But, direct care doctors, as we can testify, and so many others too, love our model because we get to spend time with our patients again. Even Congressman Phil Roe recently said:

“@AtlasMD, you sound like medicine as it should be… fun.” – Congressman Phil Roe [CLICK TO TWEET]

And it’s the fun of practicing medicine again that satisfies the Dionysian aspect of direct care.

So using Peart’s logic, it looks like direct care is the total sphere, both the logical and passionate hemispheres. That deserves a soundtrack. How about some Rush?