Can medical services and drug companies survive each other? Let take a look at two very strange bedfellows.
The drug companies represent rampant capitalism at its best and worst. Medical services are the epitome of the socialism at its best and worst. The two opposing concepts exist in tandem and are mutually dependent. Both are being criticized. The criticisms are almost stereotyped. The companies are accused of being manipulative and profit driven and the services profligate and mismanaged.
Services are badly run. The core phrases are “cost management” and “risk management”. The core sentiments are how to avoid being caught out: Caught out mishandling money or caught out legally. The guiding principle of helping and healing the patient does not appear. It’s obscurity enshrined in goals, benchmarks and constant measurements.
Medical management has refused to manage. It has failed to say what it can and cannot do. It has failed to prioritize its role and function. It has failed to look at the best and cheapest ways of achieving what it is supposed to do. As a result the public expect both everything and nothing. Doctors have become the recipients of the latest managerial fad and demand. It's as if the doctor is there to satisfy the needs of the managerial class and not his patient.
Third party payment however puts a lot of money in the hands of the managers and who better to relieve them of this burden than the drug companies? The companies have convinced themselves that medication is the “only game in town”. The Services went along, as that was the line of least resistance. A lot of pressure is exerted through self-serving” research” and its funding by the drug companies. This pressure points in one direction. Medication is best. Funding must be found.
This is very wrong.
Medicine is based on prevention, rehabilitation and cure. Drug companies are only selling the “Magic Bullet”, namely cures. Today’s medicine is being dragged along for the ride. Drug companies search for new ways of selling drugs. They create a sense of need. This is the capitalistic ethic. But it is swallowing up money needed for prevention and rehabilitation.
Even more dangerous are the manipulations of the generic drug market. The generic market means that one patent beating drug company can sell a package of drugs and manipulate the market. This may eventually threaten research.
The machinations of the drug companies and medical services have had catastrophic affects. The basic unit, the doctor-patient relationship has been discarded. The doctor is overburdened and dissatisfied, the patient alienated and confused. The result is a new alliance between them, which threatens politically the basic concepts of third party payment. Third party payment, which was conceived in politics, can be aborted politically.
Medical management must wean itself off the “market model”. It must provide a service structure that allows accountability in its core functions. Drug companies will have to realize that they must provide a service that is felt to be genuine even though it may “compete “ with their medications. This service must include cheaper, yet less attractive , to the drug companies, prevention & rehabilitation.
The ideal and maybe only answer is for the drug companies to enter the fields that are needed. This would mean offering managerial services, training, managing, prevention, and rehabilitation programs. They should do this not as a fob or gimmick but to enter the field to make money. That is their real “raison d’etre” and there is no shame in being true to this.
This is a profitable exercise because in many instances the three fields, prevention, rehabilitation and cure are not mutually exclusive. In all probability the medical services could harness the managerial skills found in the drug companies. The services should be sold as economic packages.
An ideal solution would involve that both the services and the companies realizing that they have to either “hang together” or be “hung together”. Only by utilizing the positive aspects in both will they overcome the threat that has arisen from the synchronization of their weaknesses.