The next time you go down to your friendly, neighborhood physician, be sure to wish him or her a fond farewell. The sun may be setting on our illustrious healers, who appear bent on going the way of bobby socks, juke boxes, and barber shop poles in the continuing saga of vanishing Americana. We have no one to blame for this, but ourselves. We were just not hungry enough, and we let our guard down. Our elite position in the world’s pecking order burned stone cold, as legions from Bangalore and other faraway places fueled a reverse brain drain that now threatens the U.S. medical sacrosanct and weakens the very foundations of our medical institutions. Think about that when you try to decipher the names and places etched in cursive ink in your medical chart, that is, if you are even provided an opportunity to view such a document and navigate its hieroglyphics.
Now, while there are positives to the outsourcing of U.S. medicine, I prefer to concentrate on the negatives, in order to possibly salvage that which I believe in and hold most dear. I did not become a physician to observe glory’s wane and the baton passed into the hands of a foreign infidel whose primary concern is financial. While you may or may not agree with what I have to say, you cannot negate the main premise of this piece: that rising health care costs have driven federal and local authorities, large corporations, major health care institutions, and heads of households to seek cost-cutting alternatives to “greenback hemorrhage.” If, however, the main impetus for change is strictly monetary, we are inadvertently inviting an unwelcome guest to dinner who will most certainly overstay his or her welcome.
It goes without saying that outsourcing medical expertise and judgment to exotic places creates a fertile environment for the germination of charlatans in the ranks of competent providers. How will we differentiate well-schooled and weathered medical professionals from the chaff, when different laws, value systems, and licensing criteria cloud the transparent process of medical qualification uniformity?
Human nature being what it is, patients are always going to need, as well as choose, local physicians and hospitals. We must accede to those preferences in a truly connected and digitalized world by finding ways to provide the highest standard of medical care at the lowest price. A competitive edge we lost some time ago must be regained. Otherwise, U.S. physicians will be relegated to the same junkyard populated by the U.S auto, manufacturing, and textile industries.
Many argue that technology has provided a cost-effective means for the U.S. health care market to remain solvent via cheap, remotely placed language interpretation services, reading of radiographs, interpretation of laboratory tests, patient monitorization through electronic intensive care units in real time, billing, and other varied medical services by lower-wage foreign professionals whose appetites for material gain have paled in comparison to those exhibited by their American counterparts. Furthermore, non-U.S. physicians are all too happy to buttress fiscally challenged U.S. hospitals and to free domestic providers from off-hour duties and round-the-clock services. Therein lies their attractiveness.
Beware of what you ask for, however! We, as a nation, must pose two questions: are we willing to put American physicians out of work for the sake of lower prices? And how much money are we going to borrow from China to rebuild our failing health care system? If we cannot find answers to these queries, then I’m afraid the future health of our nation looks grim. We must be pragmatic, and, generally speaking, that means an open-minded change in course, policies, and doctrine when they do not work. Specifically, while we seek better training, technical skills, and delivery systems for our health care professionals and institutions, we must not lose sight of the fact that low-tech is not a bad thing. Local doctors and hospitals can go far by enhancing those proven practices and patient empathy, which are best delivered in person. Building on what they already do best, while at the same time increasing their competitiveness in the world arena, will keep our physicians closer to home, even as the outsourcing controversy continues.
As our sons and daughters begin to set, this is no time to bury our heads in the sand!
© 2006, Albert M. Balesh, M.D. All rights reserved.
