From 1969 to 1976, a favorite American television show was one of the early medical drama programs, the popular Marcus Welby M.D.
Medical drama has continued to be a well-watched topic, beginning in the early 50’s, and includes Dr. Kildare, Ben Casey, M*A*S*H*, Dr Quinn Medicine Woman, City of Angels, Grey’s Anatomy, E.R., House and many others. The main characters are usually kind and loving, dedicated folks. After all, it is all about doctors and nurses taking care of people.
Medical Drama in Real Life
But another drama has changed the face and function of medicine. It’s been a slow, insidious, now dramatic change that has allowed big corporations to wedge themselves between the kind, loving, dedicated doctor and the patients who need medical or dental care.
Beginning back in the 40’s, the drama of insurance company/corporate involvement in medicine began. The 1945 McCarran–Ferguson Act, created a United States federal law that exempts the business of insurance from most federal regulation, including federal antitrust laws to some extent.
Anti-trust laws apply to doctors, but insurance companies are exempted in some ways. Insurance companies, corporate dental, Medicaid, Medicare, calling themselves healthcare (insurance-speak for we-want-you-to-pay-us-for-your-disease-care), began the drama which has resulted in:
1. Reduced quality of patient care as the time per patient is reduced, fee schedule charges for care are reduced, then split between corporations and doctors, certain treatments are “denied” (insurance-speak for we-won’t-pay-you-for-providing-that-care-to-your-patient), corporations recommend changing your delivery system (insurance-speak for reducing time, quality, materials, etc. in your care), and perhaps most egregiously, corporations are now defining what periodontal disease is, or what is medically necessary, etc. (insurance-speak for diagnosis- diagnosis that should be done by the professional, educated, licensed, experienced, wise doctor);
2. And, all the while, untold dollars in the coffers of the smart corporations, and great reductions in the doctors’ ability to make a living while they scramble to care adequately for patients.
The real-life, shall we say, soap-opera drama has evolved. Your “provider” (insurance-speak for doctor) contracts with the corporations are regularly changed to the benefit of the corporations, though you of course sign them and agree to abide by them.
The insurance companies re-contract with the employers who buy the coverage for their employees, and each new contract has the potential to “save the employer money“ by removing coverages and limiting payments out. These various changes further pour your profits into the corporate coffers.
A New and Wonderful Medical Drama
Doctors, we are here to change the world. We are here to love, to care, to transform lives, and through those transformations, the lives of related and others.
Avrom King, a psychologist and health-care “futurist” pointed out, orthodontics is not about teeth actually, but about how the result of the treatment affects a person’s self-image.
This is true across the spectrum of dentistry. Ours is a behavioral art, where love and caring are far more important than the mechanics of the dental and orthodontic treatments.
Dr. F. Harold Wirth, who was Dr. L.D. Pankey’s closest friend and speaking partner for many years, considered hugs to be a key metric on how well we are connecting with - and therefore truly helping - our patients.
It is time to understand that your calling in your life, in medicine, is best undertaken and advanced, outside of the corporate world. If this speaks to you, then you know you are here to change the world. Your love, your strength, your relationships, are your gifts. You can engage with your patients and the world in a new way.
To do anything less, is to sacrifice yourself and the gift.