that while the business of medicine does sometimes make money, medicine cannot be run like a traditional business?
I can't possibly say it better than Dr. Whitecoat at WhiteCoat Rants. On his blog, he posts a link to an editorial by Kevin, MD, a response to Kevin's article, and Dr. WhiteCoat's own response to that response. Please go read all three. My blood is boiling.
Listen, all you MBAs and businesspeople who think that you've got a handle on how the "business of medicine" is going wrong: People are not egg timers. Diseases are not just broken cogs and gears to be fixed and then everything is good as new. You sometimes can't predict results of things--you may not be able to manage time or money in any predictable way when you're dealing with actual human beings on both sides (producer and consumer) of the equation.
Most things in business don't apply to medicine. Let's look at an example near and dear to my heart: Guitars.
I buy a guitar for $500. Is that the end of the story? No. I have to buy strings and picks if I intend to actually PLAY the thing, as opposed to just looking at it. I also have to get it "set up," or adjusted for optimum playing enjoyment.
If I take my guitar to any competent luthier (or "guitar fixer-upper"), I will undoubtedly see a sign that informs me that it costs $50 or whatever to just hand over my guitar so the luthier can tell me what's wrong with it. Even if I don't choose to have the guy DO ANYTHING, I still have to pay the $50. It's called a bench fee. If I don't pay the fee, I can't get my guitar back.
Apply that to medicine. If I have a medical problem, I can go to a doctor in the emergency room (or "people fixer-upper"). I don't have to pay anything to see that doctor, and if he fixes me up? I don't really have to pay him! Even if I don't have insurance! He's supposed to take care of me ANYWAY, because the law says so!
Yeah. That's really the same thing.