Diagnosis, prognosis, prescription, payback?

29 Jun

In the back bedroom my husband is catching up on the Mariners game on his laptop. I tune in only when the name Michael Saunders comes up, since he’s a relation, which makes me a fan. But this isn’t about baseball, or even sports. An advertisement for a surgery center is deftly inserted into the game commentary. Advertising surgery clinics? Seems inappropriate, unprofessional somehow. Can’t that money go somewhere more useful in the field, like maybe gas money for carless sick people to get to the hospital? Must those surgeons compete for customers–ahem, patients? Used to be only chiropractors who did that, even offered discount coupons in those envelopes along with DQ and lube shops. Hence the hard time I had accepting these practitioners as legitimate. Now surgeons are doing the same. Can a woman hold out for a two-for one mastectomy sale offered by the new surgeon in town? And isn’t it so cute to see those ads and brochures with the white coated doc surrounded by his team of subordinates? Am I supposed to gain confidence from the existence of so many well-groomed female assistants? Better than including the doctor’s spouse and children in the feature, like so many local businesses. “Oh, that’s S____ from my daughter’s class. Her father does carpet cleaning? Lets’ hire him!” “What a nice looking family! I’ll call the company about our lighting needs!” Apparently the leap of logic from “I know him” or “I like his appearance” to “He’s the best choice of doctor” is still too great for most people. With the current trend away from teaching logical thinking, we’ll get there before long.

Then there’s the medical product trade. My optometrist, one I followed from his debut at Costco to his own practice because I liked his professionalism and thoroughness, now escorts me out front  after my appointment to deliver me to the optician in his spectacle shop as if the transformation from patient to consumer is the most natural thing in the world. I stiffen, politely browse, and say thanks, I’ll be shopping around. Will the surgeons come out with a special line of proprietary bandages next, on contract with Disney? Or maybe certain medical groups will take out stock in certain pharmaceutical companies and then, well, why not–write preferential prescriptions. Oh, I forgot–isn’t something like that already happening? Or am I thinking of auto dealer service departments?

I’m not liking that cynical tone, are you? Okay, I’ll back up, and ask, in a neutral tone, like a good CBC journalist:

  • What is the role of the business model in the medical field?
  • How can medical professionals and facilities inform the public about their services and qualifications in an accessible, truthful and balanced way, so that prospective consumers–ahem, patients–can make informed choices?
  • Is there a role for market competition in the provision of medical services?
  • What are the most effective structures of accountability for medical providers marketing their services, or selling products related to their own medical advice?
  • What business-related activities could constitute conflict of interest for a medical provider?



Posted by on June 29, 2014 in Economics


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3 responses to “Diagnosis, prognosis, prescription, payback?

  1. jdawgsrunningblog

    June 30, 2014 at 7:00 am

    It’s cool to see this piece in the context of so many of your others—you seem to be a kind of journalist at heart–blending the best of both worlds–as your prose style is often poetic. For some reason–I kept thinking Molly Ivins–when i read this piece–are you familiar with her work?

    • toesinthedirt

      July 2, 2014 at 9:26 am

      Was not. An interesting and very complimentary comparison. Thank you.

  2. LeRoy Pick

    October 7, 2014 at 8:52 am

    I echo the previous comment. An excellent, well written article. (Although I will ask about your quoted “best choice of doctor” line. Is that your language or theirs? “Best choice of doctor” would apply to selecting a heart surgeion over a podiatrist to perform your triple bypass, while “best choice for a doctor”, meaning the best doctor of his type, would likely be the correct language when shopping for a doctor.)

    I can agree with your discomfort and cynical tone regarding advertising with medical practitioners. It reflects poorly on the profession, to my mind. Thankfully, here in the Great White North, it’s still very much an anomaly. I think it’s unfortunate that more people aren’t asking the questions that you have posed.

    Advertising is absolutely out of control in the modern era; look at the companies (Google, Facebook, and Twitter to name three) whose sole source of revenue is the advertising and quid-pro-quo sponsorship deals they work out. If that’s not a sign things are berserk, I don’t know what additional proof one would require.


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