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Hello Dr. Feld,

I just wanted to drop a line to tell you that I have enjoyed the articles that you have posted so far! I am looking forward to learning more about your thoughts on the US healthcare system. Your perspective is very valuable to me as I am a budding physician myself (just finishing 3rd year of medical school) and I would like to help fix things, but it's so overwhelming from where I stand that I don't know where to start or what would be most useful for me to focus on. Do you have any advice for a beginning physician?

Thank you!

World Class healthcare, world class doctors, world class medicines and treatment.

Only if you are superrich and can afford to pay for it or if you have insurance and if you have the patience to sit through medical hell! The patient always seems to come last as Dr.Feld observed!

Looking forward to your blog, Dr.Feld! You may already be aware of Dr.Don Berwick's efforts in Healthcare Improvement - http://www.ihi.org/ihi. Interesting articles in this web site. Would love to hear your take on his efforts!

I think Insurance as a concept applied to Healthcare is failing. Everybody thinks somebody else is paying and everybody pays as a result! Health insurance will work only if it is for serious illnesses. For simple ailments if doctors charge and patients pay directly, a lot of the inefficiencies will be cut out and at least simple healthcare will be cheaper! That's just my guess! I am only a software engineer and somebody like Dr.Feld will throw more light on the nuances of the healthcare industry to test this theory!

Thanks & Regards
Nari

Dear Nari

My goal is going to explain how you can help repair the system. Thanks for the comment. Never devalue yourself. You know more than you think

Stanley Feld M.D.,MACE

Dr. Feld - I look forward to reading your exciting blog. Let me try and post some initial provocative comments to get your blogging juices flowing:

1. Do you really think that a healthcare system based on capitalism can be fixed? Seems like physicians want more compensation, insurers want more premiums, and patients want lower costs. The art of medicine has and will continue to be a service and not a commodity.

2. Looking at the ends of the spectrum of medical providers you will see many interesting trends. Older physicians going out of private practice and retiring sooner with less income, new physicians driven toward higher paying subspecialties and managed care organizations or groups. So where is the next generation of general care providers coming from?
I think the resistance for universalization may be largely based on fear that compensation will further decrease.

3. Patients obviously want choice in care. Even if choice were provided, is the average patient even capable of choosing? Since the beginning of managed care, there has been a hunt for control of patients and insurers have captured many populations via marketing campaigns. To what extent will patients have freedom of choice as they lock themselves into the intricacies of various plans?

4. Lastly, it is obvious that patients in the US will continue to demand the best available treatments and procedures. Can the government continue to bear the cost of reimbursements without bankrupting the country?

I look forward to your thoughts.


jchen@cxoventures.com

All Important questions and statements, I hope to address in the coming months. As I said the problems you raised are not going to be fixed with a patch. They will be fixed with an understanding of how we got here and how we create a paradigm shift

Stanley Feld M.D.,MACE

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