Medicine and the Twilight Zone 2013: To Serve Man

Author/contributor: Marilyn M. Singleton, M.D., J.D.

During a discussion on the future of health care, a clinician-turned-healthcareexecutive told me that the way we “deliver health care” (not the same as “practicing medicine”) will change. It will be a “process”—a more mechanized one. She spoke enthusiastically about the advantages, such as electronic health records. These can improve fraud detection in government programs with computerized cross-checking of services delivered and payments made. This of course misses a larger point. If we didn’t have enormous government programs, fraud would not be so easy to perpetrate. It’s pretty hard to double-bill a patient when there is no middleman. Patients generally remember whether they were in the doctor’s office last month. A patient who was not in a coma would immediately let the doctor know that she did not have that colonoscopy.

The executive was not concerned about the erosion of privacy. These days, she said, all of our information is in the ether anyway. If you are a random person, no one cares about your information. She did admit that the revelation of some conditions such as AIDS could lead to discrimination. e. What if your patient is the wife of a law enforcement officer and tells the truth? Has she just made her husband a target of disgruntled perpetrators?

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