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PT and the Greater Good

The Doctors Are Not Amused

Published February 11, 2010 10:20 AM by Dean Metz

I was in the states again this week to visit Nova Southeastern University in person. I'm studying for my Masters in Public Health online there and a visit within one's first semester is required. I met with the director, who passionately embraces all aspects of public health and for as much as I can tell, appears to ‘walk the walk' as well. Upon realizing that I was indeed working in the NHS currently, he decided that I would lead the next day's public health seminar and a single payor system would be the topic.

As Scott Bakula used to begin every episode of "Quantum Leap" I said, "Ooh boy!"

The next day I found myself facing a room of about 40 people, students, faculty and doctors who also taught at Nova. I started my discussion with, "Tell me what you know about the NHS." I heard about long wait times for treatment, bad dental care, and high tax burdens on the people of the UK. Only my director could come up with a positive aspect, which was universal access to care. The rest of the room responded with an "oh yeah, there is that."

As I relayed my experiences in the NHS, the discussions became rather animated. Never, disrespectful, but it was obvious that the doctors were not happy to have their preconceived notions challenged. One doctor asked how on earth an NHS General Practitioner could see 140 people a week to which I responded, "What if you didn't have to spend time arguing with or writing up reports to managed care companies? Could you see that many then?" He responded that indeed he could. Another stated that didn't matter because he hired an administrative staff to deal with that, to which I responded, "How much could you save by not needing that staff? How much could you save by not having to pay that staff's medical insurance as well?" He did not respond.

All the MDs complained about insufficient pay in the NHS system. See the link below, which states that the average pay of a GP (not specialist) is about 106,000.00 Pounds/year or the equivalent of $165,000.00 USD. There was an Ob-Gyn MD in the group who brought up some very interesting points. He pointed out the debt burden incurred by US doctors to become MDs. He is right, the burden on UK doctors is about 5% of what it is for US doctors. He also pointed out the problem of malpractice insurance and the constant fear and cost of litigation. When a doctor works solely for the NHS, they cannot be sued individually and are covered by the NHS.

The article that follows is from one of the daily newspapers here in the UK. It is not flattering of the current system but it does lay to rest the arguments presented by the doctors at the seminar. It was clear to me after the seminar that the health care problems in the US are not isolated to health care. They are inseparably linked to the educational system and the legal system as well. I can see many reasons why both, along with insurance companies, would not be in favour of reform of the current system. 

posted by Dean Metz


140 patients a week is 28 patients a day.  At four patients per hour, that is 7 hours a day.  

Now, when I go to the doctor, I'M there a WHOLE lot longer than 15 minutes, but I can't remember the last time I actually had 15 minutes of face time with the MD.  I'm not complaining - I feel like he is provides good care, or I wouldn't still be going to him and taking my kids there.  Really, how long does a sinus, ear, or upper respiratory infection take to diagnose?  And I have to believe most of the patients a doctor sees are those "quickie" patients.  Some will be new evals and some will be more complicated, but I'd think those would be the minority.  So the 5 minutes it takes him to diagnose then write an antiobiotic script for bronchitis, well that is 10 minutes he can add to that complex case or new eval.  So now that is 25 minutes on one patient.  I think we call that surgery.  Sorry - couldn't resist.

Yes, I know there are other duties doctors have to fulfill on their patients' behalves.  But as you said, if those are taken out of the mix, then 140 patients in a week really should be doable.  Unless he's a social butterfly, then he might be in trouble.

Janey Goude February 23, 2010 1:33 AM

True, very true and a new system can't be much worse than the one we have currently.  Maybe a hybrid system will work here, then again maybe not.  

jason February 14, 2010 10:14 PM

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About this Blog

    Dean Metz
    Occupation: Staff Development Specialist
    Setting: New York, NY – Newcastle Upon Tyne, Great Britain
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