So why do patients need to know this?

In the last four postings, I have tried to give the patient an inside look, at a face of medicine, which some health care corporations do not want you to see. As a quick review, I will summarize the highlights.

Health care is big business, over $2.7 trillion per year, and most of it takes your doctor's signature to make it happen. Because of this relationship, the medical industrial complex will do whatever it can do "legally" to control your doctor. If they control your doctor, they control the money.

Most states have specific laws against the corporate practice of medicine. The States of California, Texas, Colorado, Iowa and Ohio, have specific laws forbidding the employment of physicians by hospital/insurance companies.  Why the rest do not, is a mystery to me. To circumvent those laws, big business must use every bit of leverage it can, to exert its considerable influence over your doctor, to further its financial gain.

Depending on the specific type of business arrangement your doctor has, in his particular practice, health care corporations that do not have your best interest as a patient in mind, may be able to exert considerable influence over your doctor's recommendations for any treatment you might need. This will be most apparent if you have an expensive illness like cancer or heart disease.

With the continued consolidation of health care, many doctors have found themselves in practice situations, in which they can be summarily relieved of duty, if they do not do as they are told. These doctor-as-employee positions are often very attractive, and may pay much more than positions that are doctor owned and governed. The trade-off is that the doctor who takes such a position has essentially sold-out.  It may have been well meaning, and they may not even know they have done it because they have not been "leaned-on" yet.  But soon enough they will find out, when the health care bubble bursts.  And believe me that is coming.

Doctors whom have "not" sold-out, are proud of this, and also are happy to tell you so. Doctors that have sold-out, will be careful to avoid the question, and will be evasive with their answer.

It can very difficult to tell if your doctor is in the type of practice that does, or does not protect the physician-patient relationship. Most patients are oblivious to this important point. You want a doctor that works for you, with as little interference from the outside corporate world, as possible.

Doctors should get paid for what they do for you, not what they do for their employer. If your doctor is getting paid more than is justified by his productivity and time, on behalf of patient care, then he isn't really working for you any longer, he is working for his boss, whomever that might be.

That basically sums it all up. So now I ask you, is this really important to you as a patient? Does all of this matter? Well if you believe that your relationship with your doctor is important to your health and well-being, then you should be very concerned about the level of corporate influence over him, and as a result, you too. Your life could depend on it.

So how does one figure out if his doctor or doctors are no longer free thinking professionals, or rather just obedient employees doing as they are told for some nameless, faceless bureaucracy. That truly is the problem. There is no way to tell usually. You have to do some serious sleuthing. As I said, you can ask your doctor, but he may not be very forthcoming. He might try to hide it by misleading you. He might just flat out deny it. But the reality is, your doctor can get into all kinds of trouble for treating you improperly, or improper billing or disclosure of confidential information, but he is under no obligation to tell you the truth about who he really works for. There is no sanction I know of, under any State Medical Board, that says he has to tell his patients that he has traded the sanctity of the physician-patient relationship for a better or more convenient paycheck. Sorry, you are on your own.

 Then again, maybe not?