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Fixing Healthcare: Stop Treating the Symptoms Instead of the Disease


Doctors are taught to be diagnosticians, diagnosing and treating diseases instead of simply treating symptoms. When it comes to the transformation of healthcare, doctors need to take their own advice.

Practice Management, Physicians, Healthcare Reform\

Doctors are taught to be diagnosticians. They are not supposed to just treat symptoms. Given the fact that medicine is an art, sometimes we succeed and sometimes we don't. We are making that mistake trying to fix our sick-care system. Here how:

1. We are ignoring the behavioral, mental health, and socioeconomic determinants of health outcomes that are the primary determinants of health disparities around the world

2. We are focusing on sick care instead of health.

3. We are relying too much on high tech instead of high touch.

4. We are conforming to rules that lead to dysfunctional IT systems instead of changing the rules to allow us to build what patients and doctors want and need.

5. We think we can solve very complicated problems, like cancer, by simply declaring war on them.

6. We continue to recruit and train knowledge technicians to fight the last war.

7. We are relying too much on patients to be smart consumers.

8. We are treating minor symptoms instead of major diseases, e.g. our inability to change doctor and patient behavior.

9. We are suffering multi-symptom organ failure. We need to focus on those that are life-threatening and not merely annoying, e.g. not focusing on the 5% who spend the 50%

10. We are afraid to treat the disease with high-risk solutions and, instead, offer low-risk solutions for the symptoms, e.g. tinkering with a fundamentally flawed Health IT approach and rethinking the entire enterprise.

Take a history. Perform a physical exam. Make a diagnosis. Recommend a treatment plan. There are times when using an unspecified ICD-10 code is justified. This is not one of them.

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Victor J. Dzau, MD, gives expert advice
Victor J. Dzau, MD, gives expert advice