Rather Suspect

Recently I heard the term “band-aid medicine” used to describe much of so-called Western medicine and I must say it resonated with me.

The concept is that a medical professional, when presented with a set of symptoms, looks to allieviate the symptoms rather than identify the root cause. I’ve experienced this myself recently and found it confusing. Why would this be?

It feels to me one key to this is, sadly, simple the incentive structure built-in to our medical system. In my experience anytime I’ve seen a doctor, they are paid per visit (and in a very opaque way, wherein my portion is the “copay” regardless of what it is they did during that visit.) If I had a business where I got paid each time I interacted with someone, guess what? I’d find ways to see 20, 30, 80 people each day. And during each visit, I’d be thinking “the clock is ticking.”

This summer I saw an orthopedic doctor regarding some lower-back pain. At the start of the visit I mentioned that I had an old injury in my upper-back and wondered if that might be related. Exasperated, she replied, “how do you expect me to examine both your lower back and your upper back in only 40 minutes? Please schedule another appointment for that.”

Who said anything about 40 minutes? And since when is the state of the upper back “outside the bounds” of an examination of the lower back? But, of course, she was “on the clock.” I have no insight into her compensation but I wouldn’t be surprised if she received a bonus based on the number of patients she saw in a given quarter.

Given this, is it any surprise a doctor wouldn’t want to put a “band aid” on your ailment as quickly as possible and send you out the door?

But — certainly there must be a solution to this. An incentive structure which rewards healers (note that word) who actually succeed in identifying and treating the root cause of any issue.

Does this exist anywhere in the world I wonder — at scale? Yes, I would imagine if one has the means, one can always hire the appropriate individuals. I doubt Bill Gates or Jeff Besoz lack for medical care. But what’s the appropriate solution for the other eight billion humans on the planet?