How to keep yourself safe and get the quality treatment you need
One of the big problems with modern healthcare in the U.S. is medical overspecialization. Physicians these days tend to have a blind focus. That is, they’re learning more and more about less and less—specifically when it comes to the holistic health of your body and mind.
These doctors are looking at your organs as a series of disconnected parts. And they’re quicker than ever to recommend numerous drugs and procedures that only affect the medical condition they’re specifically interested in. All while essentially ignoring the toxic side effects these “solutions” can have on the rest of your body and brain.
Studies show that most people have better health outcomes when they visit primary care physicians (like family practice doctors, pediatricians, and general internal medicine doctors), instead of putting their health in the hands of medical specialists who over-diagnose and over-treat. This particularly applies to cardiologists, urologists, and orthopedists—who I view as the “big three” threats to safe, natural, and holistic healthcare.
In fact, one meta-analysis of 10 studies found that the more primary care doctors a state has, the better the health of its residents.1
The researchers reported that adding one primary care physician per 10,000 people decreases average mortality by 5.3 percent.
Why there’s a shortage of primary care doctors
Despite the huge amounts of money we taxpayers spend on subsidizing our dysfunctional (and frequently harmful) healthcare system, a growing problem is that there are simply not enough primary care physicians to go around—either to provide general, holistic care, or to grant access to medical specialty care when you really do need it.
In fact, a new report from UnitedHealth Group found that only one-third of U.S. physicians are primary care doctors.2 It shows that 13 percent of people nationwide (almost equally urban, suburban, and rural residents) don’t have any access to a primary care physician.
In my view, one main reason is because specialty medical care pays better, making it a more attractive option for new doctors with massive medical school loans, and making up for many prime years spent in school, out of the workforce. The UnitedHealth report found that in 2017, only one in six med school graduates chose a primary care residency program.
Also, the report pointed out that primary care physicians work grueling hours. A physician who serves 2,000 patients (which is certainly not unheard of, especially in rural areas) would need to work an impossible 17.4 hours a day to provide all the primary care those patients need.
Finally, the attraction of being a small-town primary care doctor has waned in the 21st century. The problem is fueled by a lack of health insurance providers in rural communities due to the Affordable Care Act (Obamacare). (For more about this, see the sidebar on page 5.)
Other problems with healthcare
Of course, not all medical specialists are unnecessary. Modern medical technology has created some nearly miraculous treatments for certain conditions when appropriate and when indicated—such as heart valve replacements or cataract surgery.
But unfortunately, you may never be able to use these treatments. Health insurance companies block access and reimbursement at every turn, until you finally get on Medicare.
And when you are able to visit a primary care doctor or specialty physician’s office, there may be another problem…
We often think of a doctor’s office or clinic as a healing place, or at least a safe space. But it’s also a complex workplace—especially in large specialty or multispecialty group practices—with many employees.
And despite all of the emphasis on “empathetic” workplaces today, and the utopian demands and expectations of younger employees, what goes on in these healthcare settings is shocking.
In his new book Dying for a Paycheck, Stanford professor Jeffrey Pfeffer cites evidence showing that toxic workplaces are the fifth leading cause of death for Americans.3
The characteristics of what Pfeffer defines as a toxic workplace sound like a model description of a typical healthcare setting—with employees feeling they can’t speak their minds to physician “bosses,” or receiving more criticism than praise, or getting the short end of the stick when doctors devote too much attention to prima donna practitioners at the expense of other employees, and more.
So it’s no surprise that in addition to burning out their employees, physicians and surgeons themselves suffer from higher rates of burnout and suicide, as I’ve reported before. And that contributes to the growing shortage of healthcare workers, making it even harder for patients to get quality care.
4 easy ways to reduce your dependence on doctors
Of course, there’s nothing you can do about any of the factors I just mentioned.
But you can take control of how the current state of medical care impacts you—and you can reduce your number of visits to the doctor in the first place.
Here’s what I recommend:
1) Avoid useless “preventive screenings.” Unless you have specific risk factors, yearly mammograms and prostate screenings aren’t really necessary. Same with colonoscopies (as I’ve often reported).
In fact, if your doctor recommends any kind of test, I suggest checking the American Board of Internal Medicine’s Choosing Wisely website (www.ChoosingWisely.org). It gives you well-researched explanations of many common tests, along with the pros and cons of undergoing said tests.
2) Consider major medical or hospitalization insurance. This useful type of insurance was formerly impossible under Obamacare rules, but it’s now allowable with recent changes.
Major medical insurance slashes your premiums while still covering you for the “big stuff.” And you can spend the money you save on the healthcare you really need that isn’t covered by most insurance plans—including mind-body therapies, massage, naturopath visits, and acupuncture.
3) Eat right. A balanced, Mediterranean-style diet and high-quality dietary supplements can go a long way toward keeping you out of hospitals and doctors’ offices.
4) Spend time in Nature. Moderate, outdoor activities on sunny days (like walking) can help your body generate vitamin D, improve your mood, and lower your risk of chronic disease. And all it takes is a total of about two hours per week!
It’s worth noting that one of the most popular books in colonial America was called Every Man His Own Doctor. Nearly 300 years later, it’s still a good alternative to today’s dysfunctional medical practice and healthcare system.
Healthcare in rural America
A new Henry J. Kaiser Family Foundation report echoes what I’ve said all along—that the Affordable Care Act (Obamacare) is all about “urban health.” According to the report, in 2018, 87 percent of all ACA enrollees lived in metro areas.4
The worst predictions that some rural counties wouldn’t have any ACA health insurance providers at all by 2019—and that 50 percent of rural counties would only have one provider—didn’t entirely come true (probably because the new administration in Washington began correcting the worst of these problems last year).
However, the report does note that five entire states with large rural populations (Alaska, Delaware, Mississippi, Nebraska, and Wyoming) now have only a single provider.
The report also points out that while insurance company profits are actually increasing under Obamacare, insurers are leaving the ACA marketplace at least in part because of “legislative and regulatory uncertainty.” So we can likely expect even worse rural healthcare and insurance as the lingering effect of Obamacare drags on.
Information technology could help provide a partial solution through telehealth video conferencing (interacting with primary care providers on a computer) that offers healthcare outside an office setting.
In fact, the technology is available and doctors are willing—but they’re facing problems getting reimbursed by our old friends in the insurance industry. Meanwhile, these same insurance providers have no problem transmitting your x-rays and imaging studies all the way to India to keep from having to reimburse more expensive U.S. radiologists.
Sources:
1“Quantifying the Health Benefits of Primary Care Physician Supply in the United States.” International Journal of Health Services, 37(1), 111–126.
2unitedhealthgroup.com/content/dam/UHG/PDF/2018/UHG-Primary-Care-Report-2018.pdf
3gsb.stanford.edu/insights/workplace-killing-people-nobody-cares
4kff.org/health-reform/issue-brief/insurer-participation-on-aca-marketplaces-2014-2019/