The Doctor Will IM You Now

Dr. Parkinson concedes that the primary-care system is broken, and his proposal for fixing it is to increase its efficiency. As a holistic health care practitioner, research scientist, entrepreneur, and author of several books on illness prevention, I take exception to that approach. Inefficiency is not even on my list of why the system is broken, and making it more efficient will just make it more broken, especially when it comes to the prevention and treatment of chronic illnesses. Here is my proposal:

We need an Office of Illness Prevention (OIP). It must be independent of: the food industry, the industry-controlled FDA/EPA/USDA triangle, Big Pharma, the Surgeon General, and the NIH. It would conduct government funded university research into areas that have been completely ignored, such as using nature as a paradigm for health. I have personally already funded such research with great results. See my books: "The Wellness Project" or "The Original Diet ??? The Omnivore's Solution" for details.

The OIP would include an anti-revolving-door policy to avoid be compromised by other institutions. All of the research from the OIP would be posted free of charge to the world community, and there would be open dialog and feedback between consumers and the OIP via the web. Prevention should be part of a mandatory curriculum taught in every medical school. Ultimately, Illness Prevention would become a worldwide initiative, changing the face of health and health care as we know it.

Roy Mankovitz, Director
www.MontecitoWellness.com

Why are insurance companies not exploring the use of technology to provide healthcare in a more consumer friendly manner, and with greater efficiency. Think about it; the average 30 min doctors visit could take about 3 hours. 15 mins to dress and leave house, 30 each way to travel equaling an hour, 45- 60 minutes paperwork and wait time both in the lobby then in the room until the doctor visits, then finally perhaps 15 minute visit with the doctor while you tell him why you made the appointment and he writes out your prescriptions. After the doctor leaves the office you again wait until the nurse comes into the room and officially discharges you by making sure you understand the prescription and doctors orders. You then need to go to the office, pay your portion of the bill and make a follow up appointment. If you are known to the Doctor and are in reasonably good health, many of these face to face visits could be done online or through texting. If the doctor is unsure about what your symptoms mean and would like you to have labs done, he could order these labs online. Physicians insist on seeing patients face to face because they know that most insurance will not reimburse them for distance visits or intervention. This argument is even truer when considering behavioral health. These visits can also be done using technology, especially if the client is known to the clinician through at least one face to face contact. If the insurance companies would open up to the idea I believe they would be able to address some of the potential problems, (i.e. confidentiality, access etc) and see that all their members can have quality care no matter where they live. A workman is worthy of his wage (quote from the bible), and there is no shame in being paid for your service, however health professionals become more disgusted by the bureaucracies that they have to deal with to be reimbursed, than they are by the actual reimbursement rates. If the interactions between health care providers and their payee sources could be simplified and less time consuming there would be more time for that quality care everyone is talking about. As a provider of behavioral health care myself I know I really appreciate some of the insurers making it easier for me to file claims online and to look up benefits for my clients. Now if they would only allow for us to meet with some of our client???s using the same technology it would be great.

Gee, cash only for young healthy patients who generally don't get sick? Sign me up as a doctor. Maybe I ought to go one step farther and open up a hospital. But only one open between 9-5 Monday-Friday. And not for old or sick people - they're pretty complicated. And I might have to take care of them in the middle of the night or something. I just want the healthy and wealthy. My revolution wouldn't include them, of course.

BTW - "Web 2.0, Social Media, Facebook, don't-trust-anybody-over-30" jargon aside, how is this any different from concierge medicine? At least those in concierge medicine accept the responsibility of caring for people who might actually need in-depth care, and they don't hide their business focus behind a load of revolutionary spin.

i am really glad i live in UK -AS even being a doctor i find the american medical system totally immoral -it is focused on not care but cash -
and this new plan is just as callous as the previous crap -

It's interesting to note that defenders of the legalized protection/extortion racket that is private 'health insurance' never seem to be able to cite any credible sources to back up their sweeping claims. For credible and scholarly research on the subject, I recommend the following link: www.chsrf.ca/mythbusters/index_e.php

The Commonwealth Fund, a private charitable organization, did a cross-country comparison and learned that next to Canada, the United States has longer medical-procedure waiting times than France, Germany, New Zealand, and the United Kingdom, all nations with forms of universal health care. In other words, yes, Canada does have long wait times but: 1) Those wait times are no longer than here, and, 2) long wait times are not inherent to universal health care.

Furthermore, the U.S. should create a medical school loan forgiveness program to encourage med students to become general practitioners.

Many physicians are not accepting private insurance. Patients need to realize that they don???t have national healthcare, the contract they do have is between them & their insurance co. Doctors are tired of dealing with the fraud & abuse perpetrated by insurance companies. Private insurance adds nothing to the quality of care yet adds substantially to the cost & hassles. Points for consideration:

1. We have the highest healthcare costs in the world - approximate 17% or our GDP. At the current rate of growth, the Congressional Budget Office estimates it will consume 20% of GDP by the year 2017, In comparison, Canada spent 9.8%. We have the highest healthcare costs on the planet.

2. Paying more hasn???t provided higher quality care. The US has poor healthcare outcomes compared to other industrial countries. The World Health Organization rated the US healthcare system 37th in the world in quality, just below Dominica & Costa Rica

3. Public systems are more cost efficient. Private insurance spend over 30% on overhead & profits. The US gov. spends only 3 % for Medicare. The McKinsey Global Institute reported that switching to a Medicare for all system would SAVE $480 billion /year, cover everyone, & provide higher quality.

So what are our choices? According to T.R. Reid there are 4 basic models:
I British/socialist: Healthcare is provided & financed by the government through tax payments, just like the police or the public library. Hospitals & clinics are owned by the government & doctors are government employees. The American VA hospital system is an example.
II German: It uses a private, but government regulated not-for-profit insurance system that must accept all applicants without exclusion of pre-existing conditions. Insurance is funded by employers & employees through payroll deductions. Doctors & hospitals are private enterprises. This system is somewhat similar to the notforprofit indemnity insurance policies common in the United States during the 70???s.
III Single payer/Canadian: The government runs the insurance program. Citizens choose doctors from the private sector. There is no motive to deny claims, no profits, so these programs are inexpensive to administrate. The American Medicare system is an example of this type of system.
IV. For profit/pay or die: The rich get care; the poor stay sick or die. Common in rural regions of Africa, India & South America, where many people go their whole lives without ever seeing a doctor. In the US, poor & uninsured may have access to emergency care but often lack access to preventive care. The IOM estimates that lack of insurance causes around 18000 unnecessary deaths/year in the US. 20% of Americans are uninsured.
How we Americans choose to reform our system remains to be seen. In the meantime, as more & more doctors refuse to accept insurance, patients will need to get used to fighting with their insurance companies on their own.

Let's make medical education free to low cost.

He's got a plan to save America's failing primary-care system!

I saw him on ABC News talking about this and i can tell you we need someone a lot smarter than this to sort things out: http://abcnews.go.com/video/playerIndex?id=4980685

Sounds like an indemnity insurance plan. Most people can not afford to pay upfront, especially those with chronic conditions. My cat's insurance works that way. I had to take out a credit card to pay her vet bill and then use the reimbursement from the insurance to pay back the credit card. The technological aspects of his business are great ideas. I use to email my doctor when I lived in San Francisco. Doctors who make house calls can be a great asset when there is an infectious disease going around. I have a chronic condition, and I'm afraid I'll get swine flu or TB or something from sitting in the doctor's office.

Another attempt by corporate media to divert attention away from the real health care problem, insurance companies, and the only real solution, national single payer.

"Appointments run $150 for the first hourlong meeting, and $200 an hour after that"

That is fixing American's health care problems?

My understanding in that doctors and nurses in the U.S. are paid significantly more than their counterparts in other countries, and that this is one of the reasons that we pay twice as much per patient, despite having short lifespans. Yet, we keep from doctors that fixing health care costs requires paying them more.

Assuming the compensation data is accurate, it doesn't look like giving doctors more money is either a laudable goal nor a step toward providing more and better care.

He better be very careful. California now says that any doctor who has a presence on the internet and "holds himself out as practicing medicine" is guilty of a felony unless he is licensed in California. If one of Dr. Parkinson's patients travels to California and gets in touch, the good doctor can be charged with a felony punishable by up to 3 years in prison and a $10.000. fine.