With the looming global economic recession, doctors and hospitals are going to have to learn to provide medical care more efficiently. This is not something most doctors in the US are good at, unfortunately. Since they live in the lap of luxury, they are often very wasteful about using scarce resources - and often overuse tests and treatments, even though they are not useful or effective. While HMOs and evidence based medicine guidelines have tried to curtail this , they have not been very successful so far.
I think rather than try to restrain doctors and not allow them to do what they want to do ( an approach most doctors resent, because they feel this encroaches on their autonomy) , if we can show them how other doctors manage to provide great medical results under the same resource constraints, then they can learn from these positive role models, and stop their wasteful practises. We need to use a carrot approach, rather than a stick approach !
Doctors have always been happy to learn from centers of excellence. In the 1920s, US doctors would do to Europe to learn from European doctors. In the 1980s, many doctors from all over the world would travel to the US to learn from US doctors. While US doctors and hospitals are still great at treating zebras, they don't do a very good job at managing basic medical problems cost effectively or efficiently.
I think they can learn a lot from Indian doctors and hospitals, who have mastered this art. Indian doctors are used to working frugally with limited resources, and still achieve great clinical results. We can be world leaders in teaching other doctors how to do this !
Talk about extremes! I used to see Dr. Khuswanth Singh in Hyderabad India until 2001 or so. He is one of those socially conscious doctors that charge a ridiculously low amount of Rs.20-30(50-75 cents) so he could treat poor patients. And I somehow got hoked to seeing him, and boy was he wonderful. He would let you in to see him at his one room clinic and even his house. And he would remember what he gave you 6 months ago s medication - and tell you that if you still had that bottle of Paracetamol he gave you several months ago, go ahead use it! What memory! Even now, everytime I go to India, just go to say hi and chat a while. I hope I am not eating into his precious time seeing poor patients. Dr. Singh is one of those selfless doctors out there. And on that topic, are you aware that a Indian doctors on rural missions conduct as much as 100 free eye operations(mostly for cataract and so on) in single weekend! I guess US can learn a lot from these guys!
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