tymshft

But where is the doctor?

I recently wrote a futuristic post in which most of the medical examination process is automated. One of my sources for the post was this VentureBeat piece that referenced the views of Vinod Klosla.

Accomplished Silicon Valley investor Vinod Khosla likens modern healthcare to witchcraft, and says technology will replace 80 percent of doctors….

Khosla said that machines, driven by large data sets and computations power, not only would be cheaper, more accurate and objective, but better than the average doctor.

Khosla made his remarks at a Health Innovation Summit, which was naturally attended by a number of doctors.

These remarks were about as successful as Ronald Reagan’s 1975 suggestion that Social Security be made voluntary – a suggestion that cost Reagan the Florida primary. Reagan lost because of the self-interest of older Florida voters, who felt that fewer young participants in Social Security would endanger their own benefits.

And there is certainly evidence of self-interest in the debate about health care. Khosla himself is an investor in medical technology companies, and would naturally benefit if these companies (rather than doctors) were handling medical needs. The doctors, who do not want to be unemployed, obviously took offense; one was reportedly “nauseated” by Khosla’s remarks. (I’m not sure how the doctor remedied the nausea.)

And there are other self interests out there, as evidenced by those who warn against the great doctor shortage.

With a growing, aging population, the demand for physicians will intensify over the coming years. According to AAMC estimates, the United States faces a shortage of more than 90,000 physicians by 2020—a number that will grow to more than 130,000 by 2025.

Needless to say, AAMC has a solution for this – increases in residency training. By the way, AAMC stands for the Association of American Medical Colleges.

However, AAMC probably does not represent the interests of another group.

At present, Belize is home to four offshore medical schools. These and other offshore medical schools in the Caribbean target students, who although they may be motivated and talented, cannot get admission to med school in the U.S.

And I haven’t even touched upon the basic composition of the death squads in the United States. Some argue that “Obamacare” will result in “death squads” of government officials who will make life or death decisions. This, of course, is contrary to the current system of privately-owned “death squads,” in which private companies deny benefits and thus make life or death decisions. Not surprisingly, some doctors who aren’t getting paid by either the government or by the insurance companies have taken matters into their own hands:

“About four years ago, one insurance company was driving me crazy saying I had to fax documents to show I had done a visit,” said Stanford Owen, an internal medical doctor in Gulfport, Miss. “At 2 a.m., I woke up and said, ‘This is it.’ ”

Dr. Owen stopped accepting all insurance and now charges his 1,000 patients $38 a month.

“When I decided to abandon insurance, I didn’t want to lose my patient base and make it unaffordable,” he said. “I have everything from waitresses and shrimpers to international businessmen. It’s a concierge model, but it’s also the personal doctor model.”

Dr. Owen, who once had three nurses and 10 examining rooms, said it was now just him and a receptionist. He has become obsessed with keeping overhead low, but he said that, for the first time since the 1990s, his income was going up.

So perhaps Dr. Owen will be one of those doctors who buys a machine from Vinod Khosla or another investor. Or perhaps Obamacare or private insurance companies will quit paying for medical care from a human.

Where does that leave the medical schools in the United States, Belize, and elsewhere?