Too Late To Save Healthcare?
Not to be too much of a downer on Monday morning, but over the past couple months (ICU and sub-internship), I’ve started to wonder if the healthcare system is doomed. (These are the fun, uplifting conversations that my roommate and I have after coming home from work.)
We talk about how the system’s already buckling under pressure, with
ERs overcrowding
and hospitals full, and it’s only 2007. (See the graph to the left to see how many more baby boomers we have to care for in the future.) And primary care
doctors are becoming fewer and fewer, drowned in a world of paperwork, less income, and specialist care, and in turn, the ERs overcrowd even more as people use them
for their primary care. And then you think how many heart attacks, rule out heart attacks, strokes, septic patients, pneumonias, and altered-mental-statuses get
admitted now, and wonder how we can possibly sustain this when we go from having 3 million people over the age of 75 to at least double that in 20 years?
We certainly don’t have the hospital capacity to deal with all these patients, nor the staff (not just doctors, but hi, we’re already in a nursing shortage). I’ll leave solving the nursing shortage issue to the nurses, since I’m woefully ignorant of it. Is it too late to get more doctors for primary care? The only way I see things changing are 1) you somehow convince internal medicine docs that’ve already specialized to go into primary care 2) you convince many, many more medical students to go into primary care or 3) you encourage more nurses and NPs and PAs to do primary care.
Even if we do improve our primary care, however, maybe we’re too late. Maybe too many patients have not been treated for their hypertension for too long (hi uninsured and non-adherent!) that they’re going to have too many heart attacks for us to handle.
Maybe we’re just victims of our own success; we can keep ourselves alive longer (in 40 years the average life span will increase by 6 years) but not alive well, just alive sick.
It’s of course nothing we want to deal with, but something we have to figure out. And it’s going to cost… a lot. I have no idea where I’m going with this. It’s too depressing and I’m going to stop now.