When health care is for profit
Goldman Sachs analysts attempted to address a touchy subject for biotech companies: cures could be bad for business in the long run.
https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patients-a-sustainable-business-model.html
This discussion is important, but not entirely new. Physicians have ran small businesses for years, although less so now. Given the years and money invested in education and training, we have deserved to make a decent living. The autonomy of being the business owner allowed us to barter for the services we provided, in old times trading care for a sack of potatoes or performing a surgery for a cow. I’m sure old Doc Williams, a pediatrician and internist as well as a poet, provided care for free here and there when a kid bashed his head from play and the parent had run upon tough times. Poem Children’s Games
This is harder if not impossible now. A physician in Minnesota Amish country had to stop providing less expensive care to his Amish patients due to Medicare’s rules. Free care is still provided, but it is organized in nonprofits and church clinics.
Given human nature, some physicians took advantage of money making opportunities, sending patients to laboratories or prescribing treatments that they profited from. Forbes: Doctors and Pharmaceutical Companies.
Although we may take the Hippocratic Oath, there are no guarantees.
Health Care is a big business these days, complicated with scientific advancement and the marvels of technology. That means big opportunities and big profits. I had a medical student with cystic fibrosis who had benefited from precision medicine.
Once the treatments were started he was able to start to run races again. His activity in CF circles allowed him to be discovered by the White House and he sat in Michelle Obama’s box when then President Obama launched his Precision Medicine initiative. Bill is likely completing his Family Medicine residency now.
We cannot go back to the old and simpler times. Patients have benefited and visionaries like Bill Gates and Paul Farmer have helped modern treatments reach much further than the wealthy world.
But the question that Goldman Sachs analysts had the courage to raise serves as a reminder. As healers we need to stay grounded in our values and commitments as physicians and use our voices. We need to work for universal health care in the US. As patients we must hold policy makers accountable as we trudge forward in this uncharted terrain.