Why do patients feel like they are treated like cows, not humans? Why does our system produce more sick people getting more procedures? Why are things so different for the patients in my new practice? It all comes down to one thing: the basic financial transaction of the healthcare system. From it flow all of the bad things doctors and patients experience. From my rejection of it flow all of the wonderful changes to the care I can now give. There is no meaningful reform that can happen without changing this basic transaction.
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Changing the focus of care to this is more than just emotional idealism, it is good business. Care should not be about codes, procedures, medications, tests, or interventions, but instead about helping people live their lives with as few problems as possible. We need an economy that thrives when the patient costs the system less.
Any attempt to reform without this change will ultimately fail.