"Money-Driven Medicine,” a film produced by Academy Award-winner Alex Gibney, presents a voice rarely heard in the health care reform debate: doctors. It takes the health care discussion away from angry town halls and puts it in the exam room.
The film presents the tricky conflict of the medical industry. A doctor’s responsibility is to help his or her patients, while a company’s responsibility is to make money for its shareholders—and the two bottom lines are not compatible. In the film bioethicist Larry Churchill explains that medicine as an industry forces doctors to focus on delivering units of care instead of results.
Doctors and patients have the perception that doing more will create better health outcomes. More units of care—more tests and procedures—do create better outcomes for health company shareholders. But more money for shareholders doesn’t necessarily result in better care for patients. “Money-Driven Medicine” points out that the country’s lowest-spending hospitals have similar—if not better—outcomes as the highest-spending ones.
According to the film, our tech-savvy country may be the culprit for this spending obsession instead of greedy health care providers. Much of the medical industry is about developing new procedures and tools. And as a society we tend to favor quick, innovative solutions to our problems. Medical innovators are trying to appeal to that desire, so doctors wind up providing supply-driven care, feeling obligated to use every piece of technology available to help patients. But by focusing so much on marginally effective innovations, doctors increase a patient’s medical bills at best—and at worst they make patients sicker.
The doctors featured in “Money-Driven Medicine” also lamented the decline of the doctor-patient relationship. They expressed a genuine desire to care for patients, but health care companies pressure physicians to see more patients instead of developing personal relationships with them.
The film calls for a shift in the way we think about health care and the way doctors are allowed to practice medicine. It encourages lawmakers to develop a set of regulations that focus on outcomes as the measure of doctor success. Rather than spend money on risky treatments that may exacerbate instead of relieving a patient’s pain, the focus of health care needs to be on effective, proven methods. We need reform that will allow doctors to get back to the issue of caring for patients as people rather than diseases.