When a child says that they want to be a doctor when they grow up, they typically have a very general view of what that means. Rarely does a child say, for example, “I want to be an ear, nose and throat specialist when I get older.” Even by the time a young person reaches the realm of higher education, they often don’t know what specific type of practice they want to be a part of.
The decision to become a specialist is not typically one of burning desire, nor is it the fulfillment of a lifelong passion. It is usually the result of a demand for a certain type of doctor. This is true for many professionals in the United States, who so often do what they do because there is greater opportunity and better pay in focusing your area of expertise to fit a very specific demand.
The problem with this tendency to specialize is that more and more professionals are losing the ability to treat people for a variety of conditions. While this might not be a big problem for people who have only one serious condition that they suffer from, it could be a very bad thing for patients who suffer from two or more chronic conditions.
This subset of patients has very particular needs, and they require many different types of medications, tests and treatments. They also need the services of many different doctors. This leads to a costly carousel of healthcare, one that threatens to put our system in a position where it is not able to provide comprehensive, effective treatment to a significant portion of our population.
About a quarter of Americans have multiple, chronic conditions, and they account for over two-thirds of healthcare costs in the United States, according the Centers for Disease Control and Prevention. This growing population is met with another trend that undermines their medical needs – the lack of general practitioners.
This combination is proving to be an expensive and dangerous mix for some of our sickest citizens. Specialized doctors play an important role in providing healthcare for people suffering from multiple, chronic medical conditions, but it is a very specific role. General practitioners can help a patient receive more coordinated care, and they are more likely to be equipped to address the needs of patients who have two or more unrelated conditions.
There are many obstacles in our healthcare system that are only exacerbated by the presence of multiple, chronic conditions. Conflicting medical advice, unnecessary hospitalizations, adverse drug events and duplicate tests are just a few of these many challenges. The sicker you are, and the more conditions you suffer from, the less likely you are to receive the treatments you need, and the higher the risk you run of being on the wrong end of medical error.
Unfortunately, the less-than-optimal experience of so many chronically ill patients is also incredibly expensive. Not only do those with two or more long-lasting conditions account for up to 70 percent of U.S. healthcare costs and over 90 percent of Medicare spending, they also bear the incredible costs through out-of-pocket expenses and encounter financial setbacks as a result.
For their part, doctors are not untrained in a wide variety of disciplines. Medical students must pass through a thorough set of educational requirements before they go on to practice medicine. However, once they dial into a specialized practice, they often lack the ongoing education required to deal with patients who also suffer from conditions that fall beyond the scope of their current practice.
To address this problem, we need a multi-pronged approach that involves patient education, greater public awareness and incentives for general practitioners. Some of these approaches will be more likely than others, but a failure to take the problem seriously will only compound the challenges facing an aging population in the years to come.
Steven H. Heisler is a personal injury attorney in Baltimore, MD. You can reach Steven by calling (410) 625-4878 or visiting his website.