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WSJ: The Doctor’s Office Becomes an Assembly Line

re: ethics in medicine

Only gonna get worse.

WSJ: The Doctor’s Office Becomes an Assembly Line

2021-12-29, by Devorah Goldman

Consolidation is wiping out private practices and making medical care costlier and worse.

Since the start of the Covid-19 pandemic, my dad’s rheumatology practice has been flooded with new patients, including many from far-flung cities or out of state... This shouldn’t be surprising. According to a 2020 survey by the Physicians Foundation, 12% of all U.S. doctors either closed their offices during the pandemic or were planning to do so within the year. Some 59% agreed that the pandemic would “lead to a reduction in the number of independent physician practices in their communities,” and half agreed that “hospitals will exert stronger influence over the organization and delivery of healthcare as a result” of the pandemic.

...This doesn’t bode well for medical care. Doctors aren’t—or shouldn’t be—natural subordinates. A substantial portion of their training consists in learning to make independent judgments rooted in hard-earned authority. Writing in City Journal in 2012, Theodore Dalrymple lamented the U.K. government’s influence over medicine, which he argued “is becoming ever firmer; it now dictates conditions of work and employment, the number of hours worked, the drugs and other treatments that may be prescribed.” Doctors “are less and less members of a profession; instead, they are production workers under strict bureaucratic control.” 

...For a long time, the AMA and other medical establishments such as the American Association of Medical Colleges quietly celebrated the turn away from small medicine. They assumed that larger, more consolidated health systems would also be more efficient. On the whole, this has not turned out to be the case. Kathleen Blake, AMA’s vice president of healthcare quality, earlier this year cited studies showing that hospital acquisitions of private practices—which doubled from 2012 to 2018—have led to “modestly worse patient experiences and no significant changes in readmission or mortality rates.”

Flawed electronic health record systems in hospitals have resulted in ghastly medical errors and millions in settlements. And while physicians in a variety of settings struggle with administrative and regulatory burdens, independent doctors are significantly more satisfied with their work than are their hospital-employed counterparts. In a 2018 survey by the Physicians Foundation, only 13% of doctors agreed that “hospital employment of physicians is likely to enhance quality of care and decrease costs.” 

The AMA has begun to acknowledge this as a problem...

WIND: government and Big Medicine are cancers that at best stop growing worse for a short while. I don’t see much hope for the future of medicine.

This isn’t news, but COVID made the problems stand out, with rigorously harsh penalties for doctors stepping out of line vs approved treatments. This surely killed tens of thousands of Americans.

And now woketards are trying to destroy all vestiges of professionalism. Any doctor worth his/her salt is going to retire earlier than planned.

This isn’t news, but COVID made the problems stand out, with rigorously harsh penalties for doctors stepping out of line vs approved treatments. This surely killed tens of thousands of American.

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