The Healthcare Gap: Harms of Profit-Driven “Productivity”
In our past blog, we discussed how a business mindset dominates the traditional healthcare model. Making the most money within this model requires a primary care provider (PCP) to see as many patients as possible.
If a PCP “maximizes productivity” by seeing more patients, then more profit results. Suppose, for example, that a physician has 20 openings on any given day. If a PCP sees fewer than 20 patients, the profit-driven business professionals “running the show” see those unused openings as “missed opportunities”.
This misguided approach is why patients can rarely see their PCP within 24 to 48 hours.
Patient Quotas Leave No Room for Short-Notice Patients
The amount of openings a physician has on any given day is that PCP’s “quota”. These openings must all be filled to maximize profit. Every possible opening should be filled by the start of the business day. Ideally, the PCP may even be overbooked.
Throughout the day, the PCP hurries through each visit as discussed in the previous blog post. Filling each opening and quickly concluding each patient’s office visit increases the chances of a PCP reaching their ideal “quota”. While this may increase profit, it also means there is no room for any patient who calls and must be seen within 24 to 48 hours.
What is the answer for patients who are unable to see their PCP on short notice? Cheaper labor.
When Quotas Are Full, Patients See Nurse Practitioners and Physician Assistants
The healthcare administrator solution to overbooked PCPs is nurse practitioners and physician assistants who see the short-notice patients. Instead of the PCP seeing their own patients, the quota system shuffles the short-notice patients to other healthcare professionals.
This decision fundamentally undermines the doctor-patient relationship that is the foundation of medicine. Worse, it has made quick visits the primary goal since those produce the most profit.
As you can see, this mindset is neither productive nor ideal for patients or their PCP. In fact, physicians who operate under this model experience shocking amounts of burnout.
The Quota Approach Is Not Productive for Doctors or Patients
A study published in the Annals of Internal Medicine reveals physician burnout costs the healthcare industry up to $6.3 billion per year. Financial costs, however, are beside the point when profit-centered medicine created many of the symptoms for today’s physician burnout.
Healthcare Dive shared a key insight on the consequences of physician burnout. Namely, the economic burden of physician burnout is not as clear as the harms that result to:
PCP well-being
PCP work-life balance
Patient quality of care
Simply, the healthcare gap is not productive or beneficial for doctors or the patients they aspire to serve.