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Beyond 7 minutes

I trained as a Family Doctor so that I would be ready to help patients with any challenge. The old school family doc used to take that skill set out into the community on house calls, sports sidelines, and town hall meetings. At some point the job description was boiled down into a job that started and ended with a 7 minute office visit. That setup is not good for patients, and it's not good for doctors. In this column I hope to start to push the boundary of where the doctor patient interaction takes place - onto the page, into the community, and beyond 7 minutes.

Building a Health Care System to be Proud of

Medicare for all has become a household phrase. Depending on which side of the aisle one’s political persuasions fall, hearing it will likely draw praise or scorn. Like so many things in American politics, health care has become a wedge issue meaning it’s more likely to divide than unite. Whether Medicare for All becomes the law, there are topics in health care that are just as important that often get overlooked.

TRUST

One important topic is trust. For people currently receiving Medicare an “annual wellness visit” does not cover any type of physical exam by a doctor. Many seniors leave these visits confused as to why Medicare does not value one of the most basic aspects of the doctor patient relationship.

PAPERWORK

Another important topic is the burden of paperwork physicians are required to do. Medicare generates huge amounts of paperwork. Much of this does not help patients heal or feel better, and certainly does not help physicians in those areas. If we extend this top-heavy administrative structure across the population, there may not be any physicians saintly enough to take on such a task.


HEALTH INSURANCE IS NOT HEALTH CARE

If health insurance is granted to everyone it means one ‘could’ see a doctor. It does not mean they will, nor does it mean if they do that it will be a favorable experience. This is a common misconception in the US where health insurance has become synonymous with health care. Health insurance is a card in your pocket, health care is a provider who you know and trust. Especially in the U.S., it’s easy to have one without the other.

HEALTH CARE EQUALITY

It is no wonder that with such variation in access to care that people are stunned and perplexed by our overly complicated system. I believe that providing more people with insurance to pay for their care is a step towards health care equality. I also think if we overlook the elements of trust and administrative burden to health care workers this equality may be of limited value. By discussing the substance of the issue rather than the political talking points we will build a health care system to be proud of.


Oren Gersten, MD