Dr. Sandeep Jauhar, M.D. posted a powerful blog entry on the New York Times website. He describes the ideal doctor-patient relationship, a place where intimacy transpires and information is exchanged openly and honestly. But he adds a caveat: “That is seldom the reality… Deception in the doctor-patient relationship is more common than we’d like to believe.”
In the post, he shares his own stories — taking care of a young woman with Munchausen syndrome, a psychiatric disorder in which patients intentionally produce or distort symptoms so they can be perceived as ill or injured; and his own deception in overriding an ER doctor’s decision let his former patient die in peace. But what’s most remarkable, is that amidst his vulnerability, Dr Jauhar laments our status quo healthcare system as a culprit in this culture of deception.
Dr. Jauhar writes,
Perhaps the most powerful deceptions in medicine are the ones we direct at ourselves — at our patients’ expense. Many physicians still espouse the patriotic (but deeply misconceived) notion that the American medical system is the best in the world. We deny the sickness in our system, and the role we as a profession have played in creating that sickness. We obsessively push ourselves to do more and more tests, scans and treatments for reasons that we sometimes hide from ourselves.
Fortunately, in direct care (where revenue is derived through a subscription, not per individual lab or test or visit), this obsessive push to do more and more is eliminated. It’s part of the reason why direct care’s subscription model can be so affordable. It’s all about eliminating waste. It’s about eliminating the deception. It’s about forging healthy relationships and giving our patient diagnoses, treatments and advice that actually work. That’s the only way to ensure patients keep renewing their subscription.
When we say our healthcare system is the best in the world, we are lying to ourselves. But we believe that direct care is a powerful and realistic opposition to the forces making healthcare costly and deceptive.
In order for it effect the necessary change, though, we need as many people as possible to say, enough with the deception. We need people to say, “I Want Direct Care.” So please, if you haven’t already, add your name to the I Want Direct Care map. Tell a friend about the possibilities of lower insurance premiums, impossibly cheap drugs and labs, and a doctor essentially at your beck and call (via whatever way you prefer to communicate). To us, that sounds a lot more like the best healthcare in the world.