Doctors make bad business people

http://blog.theentreprene…e-1#comment-464

Posting here a comment I left over at the Entrepreneur School Blog, where Jim Beach talks about the lack of business sense in doctors. If it sounds rant-ish, I apologize.

There are good reasons doctors make for bad business people (and entrepreneurs). The healthcare system is set up where the customer is an insurance company (1) and (2) practicing medicine has turned into a matter of treating symptoms rather than proactive care. In other words, the doctors expect *you* to call them when you have a problem because on the front-end (the preventative end) they largely have nothing to offer.

Case in point: medical students only take maybe a semester’s worth of nutrition. Insane when you consider that diet (and lifestyle) choices are certainly the most likely causes of people’s health maladies — so really, when it comes to having the proper tools to help patients avoid getting ill in the first place, doctor’s aren’t equipped. They are proactively/preventatively neutered.

I won’t get into the insurance company angle, but that has an impact, too. The customer has been utterly divorced from the healthcare system when you’ve got so many layers between you and your care:

you -> employer’s HR department -> [the insurance company bureaucracy] -> [hospital bureaucracy that negotiates reimbursement amounts] -> doctors who code procedures and provide you care

Simply cutting out the employer side would immediately get the consumer more plugged in as you’d have 10s of thousands of more individuals interested in getting better rates/plans from insurers than the lackadaisical corporate HR departments. I digress.

And there’s a (3) here, too. That’s that the doctor’s go to school for longer than any other profession, which makes them prone to dogmatism/procedure instead of being creative or driven to trial/error and problem-solving.

All things considered, it’s a disaster of a system. It’s no surprise it’s only getting worse. The only surprise (to me) is that so few people are talking about these core, simple problems that are making for such a disastrous healthcare system.

7 Replies to “Doctors make bad business people”

  1. Hey Justin,
    Was reading through the article and def agree with most of it. A large part of the issue IMHO is that the older doctors are very set in their ways. Many of the efficiencies that can be gained through the adoption of new technologies and business approaches will not become recognized until we start seeing some of the younger and less tech-phobic generation of docs set up their own practices. I remember seeing a presentation from a Health 2.0 summit that illustrates my point. I could not find the actual webcast or presentation but was able to track down the presenter, and his site(s).
    http://jayparkinsonmd.com/
    “Jay started a practice in NYC on September 24, 2007:
    • patients would visit my website
    • see my Google calendar
    • choose a time and input their symptoms
    • my iphone would alert me
    • I would make a house call
    • they’d pay me via paypal
    • we’d follow up by email, IM, or videochat
    This concept became Hello Health via a partnership with Myca so other doctors could practice this way. Hello Health is a mixture of secure social network and electronic medical record that enables doctors and patients to connect both in their office and online via email, IM, and video chat.”

    Hopefully this model will continue to evolve and pick up steam.

    As far as the nutrition aspect goes, I agree whole-heartedly.
    Not to get all conspiracy theory on the subject but I find it odd that Crystalline corn syrup was developed in the mid-1950’s, and proved it could compete with sugar, but it wasn’t until 1967 that they were able to convert dextrose to fructose and create HFCS. This is also about the time that heart disease followed by obesity (when it was the preferred sweetener for soft-drinks starting in the 80s) saw an up-tick. Corn subsidies happen to be some of the largest subsidies that our gov’t provides, encouraging farmers to over produce even when the market is saturated.

    Don’t get me wrong, I don’t think that we should rid ourselves of subsidies altogether but we could probably see better outcomes if we were to redirect them, say to local and regionalized operations and subsidizing healthier foods fruits and veggies as opposed to the corn used for HFCS (which is pretty much inedible to human with out major processing).

  2. Interesting Adam – thanks for the info on the Health 2.0.

    The fructose aspect to all of this makes me think of The Bitter Truth lecture that is making the rounds:

    http://www.youtube.com/watch?v=dBnniua6-oM

    If you haven’t watched it, I’d recommend taking the time even as it is an hour and a half. One big takeaway is that the metabolic pathways of fructose are similar to alcohol and that a great deal of fructose, by default will be turned into fat.

    I don’t know the answer to this, but I’m curious what are the natural sources for fructose, outside of fruit. Fruit is seasonal by nature, so if it is one of the few natural sources of fructose, then it goes to follow that human beings would only ever be exposed to fruit (and thereby fructose) at certain times of the year. Nowadays, we’re exposed to it ALL THE TIME (assuming you have a diet that in almost anyway approximates the mainstream/average diet of Americans).

    Back on doctors, I’ve now spoken with two doctors and a dentist — all have confirmed that nutrition played little to no role in their education. So they’re never even equipped with one of the most fundamental tools to help patients! Talk about systemic failure!

  3. I had not seen that vid, but will def check it out. An interesting movie that I saw a couple of years back that got me thinking is “King Corn”.

    “King Corn is a feature documentary about two friends, one acre of corn, and the subsidized crop that drives our fast-food nation. In King Corn, Ian Cheney and Curt Ellis, best friends from college on the east coast, move to the heartland to learn where their food comes from. With the help of friendly neighbors, genetically modified seeds, and powerful herbicides, they plant and grow a bumper crop of America’s most-productive, most-subsidized grain on one acre of Iowa soil. But when they try to follow their pile of corn into the food system, what they find raises troubling questions about how we eat-and how we farm”

    I’m a sucker for a good documentary.

    As far as sources of “Natural Fructose” I think that you are right that it is mainly from fruits but there is Fructose in veggies as well.

  4. Will have to check out King Corn – just added it to my instane queue on NetFlix!

    Guess veggies generally have a lot less fructose than fruits (?). OR veggies succumb to the same seasonality as fruits, so again, no fructose (or glucose for that matter) year-round.

  5. @Justin – Thanks for the link to the Bitter Truth Lecture
    @Adam – Thanks for the recc of King Corn – Note: From one documentary fan to another, check out http://docdaddies.com/ for reccs and to add commentary.

    *The comment about fructose and alcohol sharing similar metabolic pathways caught my eye. I remember reading (I believe in An Empire of Plants)that when sugar was introduced into mainstream European culture, the consumption of sugar rose exponentially in a relatively short period of time and soon thereafter alcoholism followed a similar trajectory.

    Cheers, -The other Adam

  6. my mother for example went to the doctor many times because she was having difficulty breathing and had been feeling very weak and fatigued.she had a prior history of high blood pressure, smoking,fluid problems with swelling and vertigo and irregular heartbeat.she had recently went through the house and threw away old stuff and 3 days later she was severely ill. they treated her symptoms with the atypical breathing medication and the problems continued for 6 months, slowly getting worse. she spent over 9000.00 going to her regular medical doctor, then to a lung specialist to no avail. all said it was the copd and emphysema and attributed all her problems to smoking for too long. she continually got worse with no help from the medications and developed dizzy speels. she fell due to these dizzy spells and broke her hip on top of all this
    and ended up in the hospital for hip replacement surgery. during this time spent in the hospital, it was found that the fluid pill for the swelling and the beta blocker she was on was draining her potassium to a dangerously low level. she had been taking the fluid pill and the beta blocker for 15 years or more. the hospital doctors treated her for the dangerously low potassium level, guess what, no more irregular heartbeat, no vertigo, no high blood pressure, no dizzy spells, and no breathing difficulties. my mother suffered for 6 months because the doctors failed to know or treat her low potassium level. my mother is getting better every day.

  7. I’m sure your blog is blowing up right now, from the CNN article, that’s what brought me here. I read this post and wanted to point you to a physician, Dr. Joel Fuhrman. Dr. Fuhrman wrote Eat to Live and has a website, http://www.drfuhrman.com. At a recent conference I attended he made some compelling points. 7 of the top 10 diseases that cause death are diet related. 90% of all Americans over the age of 60 are on high blood pressure medication. And once on that medication, a significant number go on to develop type II diabetes. Dr Fuhrman insists that most people on medication can reduce their blood pressure to a normal level and lower within 90 days of following a healthful diet, not a fad diet but one that avoids processed foods.

    I don’t work for him or receive any benefit for sharing this info. I do know that I’ve experienced the benefits of this lifestyle.

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