Unfortunately , the bureaucrats who assign the dollars which make the health system run, underestimate its healing value, because they are sitting ensconced in their ivory towers . Because this is an intangible, which cannot be captured in numbers or tracked, they fail to understand its significance, and try to replace it with things which they can measure ! Sadly, not everything which measures can be counted, and not everything which counts can be measured .
Let’s look at an IVF patient who goes to a super-busy clinic with a large team of doctors, as compared to one who selects a small clinic with only 1 doctor. While it's true that there are advantages in a group practice , one problem that recurs is that you often don't get a chance to see your personal physician every time . In fact, you may not even see the same doctor each time, because it’s the doctor who happens to be on duty that day who will do your egg collection or your embryo transfer. While this helps the clinic to improve its efficiency and throughput, it also makes your care more impersonal; and you need to try to create an emotional connection with each new doctor you see.
It’s only when you have had the good fortune to be treated by caring personal physician in solo practice that you understand how important it is to have a physician as your advocate . You personal doctor stands up for you ; and goes out of his way to make sure that you get whatever you need. However, when you do not see your own physician, the attending doctor i^kely to be much more detached, because he doesn't share the same emotional relationship with you . He is not likely to care as much; or do as much; or go out of his way to take the extra trouble your physician would. I think this is something we all need to acknowledge , instead of pretending that it doesn't matter.
It's not easy calculating the value and quality of the doctor-patient relationship , but just because it's not easy doesn't mean that it should be done - and until we actually start incorporating this measurement into all clinical encounters , we will never be able to fix our healthcare system.