Doctors are not actually treating illness but instead doing their best to simply manage it, a completely broken philosophy of care.
I have been reading a lot lately about jobs. The lack therein, the shortage of jobs, seems to be a current theme in some healthcare professions. The second concern I have seen most recently is the trading of senior employees for a cheaper newbie with little to no experience. There also seems to be complaints about the substitution of lesser trained individuals to do the jobs of professional level employees. This is the business of healthcare. Healthcare became a business as prices escalated and facilities became overwhelmed with the costs of doing their jobs. “Bean counters” and efficiency experts were hired to gain control of spiraling, budgets uncompensated by third party insurers. This caused the implosion of physician groups and individual practitioners. Physicians either became employees of the hospital or created groups to negotiate with the hospital for coverage. Physicians began to retire at an alarming rate because they could not convert to the digital age or meet the requirements of electronic medical records (EMR). The only method for survival was to increase the daily patient load and see patients in multiple locations. No longer was there the luxury of knowing your patients or spending time understanding their pathologies. Many physician groups have now found their groups the target of administrator bullies determined to control the delivery and price of health care.
This leads to the demise of the Purple Cow concept. In the book by Seth Godin, Purple Cow, the author shares a story about driving through the countryside with his family. As with a lot of travels, the family starts a game to pass the time. The game was counting how many brown cows they would see. As the trip continues and more and more brown cows appear, the novelty of the brown cow disappears and brown cows are soon ignored. What Godin asserts in his book is the need for a purple cow. In today’s modern world where there are so many choices and multiple variations of each one, the only way to really capture attention is to be remarkable. Nowadays, the only way to stand out is to be a purple cow. The message here is to be different and therefore, remarkable. The business of marketing has taken this to mean that you must be different in order to stand out from the overcrowded din of advertising. This leads to ads which become more bizarre each week. And I must admit, I frequently have no idea what the ads have to do with the product.
There is a conundrum and general conflict in healthcare about being remarkable and being a purple cow. This is difficult to achieve and at the same time control costs. If you peel back the onion skin and see the underbelly of patient service there will be a varnish of intentions, but underneath patient care is awash in a sea of bureaucracy. Being a purple cow doesn’t seem relevant in an atmosphere of insecurity and cost control. Rapid and sweeping change overpowers the implementation of good patient results. It has made hospitals a violent place to work where most emergency room personnel report they have been the object of family or patient abuse.
Deleting the purple cows in healthcare has produced significant dissatisfaction among patients. If a physician cannot control who works for him in the normal booking and scheduling appointments, providing an environment that is patient friendly, and assuring there is procedure follow-up, it greatly increases the de-humanization of the patient experience. Yes, healthcare must change. A system cannot be dominated by overspending and lack of vigilance. But there must be room for purple cows.