Final Research Paper – The Value of a Doctor
In recent years, greater and greater emphasis has been placed on meeting the demands of the growing population. In regards to the American health care system, the nature of medicine is shifting from treating the individual to the management of many patients, resulting in physicians influenced to be more focused on curing the disease than healing the patient. In order to follow the expectations of the progressively mechanized medical system, these doctors are more and more pressured to limit the time with each patient to maximize efficiency. The increasing compartmentalization of a physician’s time has changed the occupational structure of the field, and has consequently depersonalized patient care, compromised the original ideals for wanting to become a doctor, and diminished the value of a physician’s work.
The fact that medicine is becoming more specialized is clear. In his book, Complications: A Surgeon’s Notes on an Imperfect Science, surgeon Atul Gawande reflects on this change, “Twenty-five years ago, general surgeons performed hysterectomies, removed lung cancers, and bypassed hardened leg arteries. Today, each condition has its specialist, who perform one narrow set of procedures over and over again” (Gawande, 38) . One study showed that a growing proportion of primary care physicians reported referring more patients to specialists: in 2001, 25.5% of primary care physicians said they had referred more patients to specialists in the past two years, compared with 17.8% in 1997.
This increase in specialized care reflects the overarching trend of increased efficiency in the health care system. Narrowing the scope of focus when diagnosing or performing a procedure allows the specialist to excel within that focus due to better training and increased experience. For instance, Shouldice Hospital, a small medical center outside Toronto, specializes in hernia operations, and employs a dozen surgeons that perform hernia operations exclusively; each surgeon repairs between six hundred to eight hundred hernias a year – “more than most general surgeons do in a lifetime”i. As a result, Shouldice Hospital hernia operations take half the time and cost half the price, and their recurrence rate – compared to the general 10 to 15% of cases which require a second operation – is an impressive one percent.i
However, this approach to health care has one major drawback. The patient-doctor relationship can be fractured by the multitude of “subspecialty physicians” a single patient may have (Chen, 170) . When a single patient is divided up amongst several physicians, each responsible for a particular system or body part, personal interaction with the patient suffers. In such a setting the emphasis is on treating the disease, and the doctor is distanced from the patient as an individual.
Furthermore, more physicians are migrating from independent solo or small-group practices to larger-group practices, leading...