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Industrializing health care delivery presents many challenges.  This discussion post will review three problems associated with our industrializing of health care delivery.  They are lack of personal care, fragmentation of patient care delivery, and physician dissatisfaction.

The first problem of industrializing health care is the lack of personalized care.  In an effort to be efficient, specific questions are often asked to patients and then blanks are completed on the electronic medical record by the healthcare provider (Hartzband & Groopman, 2016).  During these visits, patients often have limited time to actually interact with their provider and therefore less time to ask questions and have more personalized attention.  In addition, trying to mass produce or use a standard set of protocols for each disease process does not always work when dealing with humans.  Patients can have simple or complex problems therefore requiring tailored care for each individual (McLaughlin & McLaughlin, 2015, p. 43).

A second problem is the fragmentation of patient care delivery.  This fragmentation presents coordination challenges for patient care (McLaughlin & McLaughlin, 2015).  For example, when a patient sees their primary physician they may undergo many different tests.  Then the patient is referred to a specialist, such as a cardiologist.  When the patient sees the cardiologists, this physician may order many of the same tests already ordered by the primary physician.  It is important for the two offices to communicate so that there are not duplication of tests which results in increase healthcare costs and increased frustration for patients.

A third problem of industrializing health care delivery is physician dissatisfaction.  Physicians lose their autonomy when health care delivery is industrialized.  They also have extreme pressure to be more efficient and see more patients (McLaughlin & McLaughlin, 2015).  This was mentioned earlier in this discussion in regards to the 15 – 20 minute patient appointments.  With declining physician satisfaction comes a decline in quality and quantity of doctors.  Previously, several surgery residents in training had an attrition rate as high as 20%.  That rate has now been reduced to 8%, but this has represented the institution of remedial training programs for current deficiencies.  It is also forecast that there will be a shortage of 20,000 to 29,000 of general surgeons by 2030 (Commins, 2017, para. 5).  In addition to physician dissatisfaction, industrializing delivery of health care is driving physicians to become employees of hospitals.  With the changes in healthcare compensation, physicians are seeing a decrease in reimbursement driving them to give up private practice and become hospital employees.  Those still in private practice are stressed with the expectation of seeing many more patients while watching their income drop (McLaughlin & McLaughlin, 2015).  At the end of 2016, independent physicians were projected to decline to 33% ("The independent doctor will not see you now," 2017).  This is compared to 57% independent physicians in 2000. 

Healthcare delivery is not “one size fits all”.  As mentioned earlier, patients have simple to complex problems.  There is a high variability of anatomy and physiology, psychological issues, etc. among patients that it makes it not realistic to have a “one size fits all” delivery of health care.

References

Commins, J. (2017). Remediation reduces surgery resident attrition. Retrieved from http://www.healthleadersmedia.com/physician-leaders/remediation-reduces-surgery-resident-attrition?nopaging=1

Hartzband, P., & Groopman, J. (2016, January 14). Medical Taylorism. New England Journal of Medicine, 374, 106-108. Retrieved from https://search-proquest-com.ezproxy.liberty.edu/docview/1757074061?pq-origsite=summon&accountid=12085

McLaughlin, C. P., & McLaughlin, C. D. (2015). Health policy analysis (2nd ed.). [VitalSource Bookshelf]. Retrieved from

The independent doctor will not see you now. (2017). Retrieved from https://www.accenture.com/_acnmedia/PDF-2/Accenture-The-Doctor-Will-Not-See-You.pdf#zoom=50