A way to fix the healthcare crisis

It is obvious that the health care delivery systems in the US and many western countries are broken and soon to be broke. Health care costs have long risen faster than inflation and are forecast to continue to do so in the future.One option to help fix the current and future problems in the delivery of medical care is to follow the way cosmetic plastic surgeons in the United States provide care for their patients. The crux of this approach is to de-incentivize the physician from performing too many tests and procedures and from providing too much care. Under the current system, the more a physician does, the more he or she gets paid. It should be the opposite. 

Cosmetic surgery financial model

Cosmetic plastic surgeons operate for the most part outside of the insurance world. Patients pay for the surgery upfront or finance it, in which case the financing company pays the surgeon for the procedure before it is performed.
The level of care is often far higher than in “real-world” medicine. My patients have paid for surgery out of pocket and expect—and should receive—the highest standard of care and attention. Most cosmetic plastic surgeons and their staff provide that higher standard. It is with the combination of great results and superb care by all the staff that my patient’s plastic surgery experience is complete. In turn, they refer other patients and the practice grows. If I am obnoxious, untrained, unprofessional or a drunk, my care will be wanting and patients will (or should) leave the practice. There is no reason why aspects of this model cannot be placed onto the greater health delivery system.

Cutting back on extra tests

The defensive practice of medicine is often touted as a great cause for the problems of medical practice today. Though important, it is not the only cause; yet, it is a cause that should be dealt with.

Tort reform and caps on pain and suffering to reduce malpractice payments is a necessary first step in providing physicians with the cover they need to practice good medicine in hospitals and offices rather than defensive medicine in courtrooms.

Medical malpractice and tort reform

I did a little calculation once.  There are 450,000 physicians in the USA. If on average they pay $20,000 (conservative estimate) in malpractice insurance every year, that is $9 billion. If US doctors paid what our colleagues in the United Kingdom pay for malpractice, the cost would be $1500 each, for a total cost of only $67 million!
Studies have shown that the cost of medical care can be reduced by 10% simply by improving malpractice laws. Every year, up to $151 billion is used in defensive medicine costs. That is a lot of money! There is room for improvement here.

Morad Tavallali, M.D., FACS


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