Yet another problem is the “consultation” business model of the medical profession.
Every single doctor that I’ve seen since 1994 is in the business of selling “consultations”. When they’ve finished their training, they choose a popular, common disease that they can make money out of and set up an office to sell “consultations”. If you have their particular disease, you may get some value out of buying a consultation. If you don’t, they’re not interested. Even doctors in the public hospital system sell “consultations”. The more “customers” they can push through their clinic, the better the funding for their department, greater standing within their little community, more prestige and influence, etc.. The fellow human-being who’s suffering doesn’t matter.
Every single doctor that I’ve seen sells consultations. At every consultation, whether it’s 10 minutes, 20 minutes or 30 minutes, at the end of the consultation they tick the boxes on the pre-printed pathology or radiology request form and send the customer on his or her way. Then they put the file away and move on to the next customer. It is the customer’s responsibility to make an appointment and then come back and buy another consultation to get the results. In 15 years, only one doctor has ever rung me with the result of a test, and even he ended up losing interest. When the customer comes back to buy their follow-up consultation, the doctor will write a prescription and send the customer on their way again, putting the file away yet again, move on to the next customer, no follow-up. It’s up to the customer to buy another consultation. The customer has to drive the process.
One particular doctor, Dr B, sold me fourteen diabetes and heart disease consultations over a three year period, even though I don’t have diabetes or heart disease. At the end of every consultation he’d tell me to make another appointment and he’d consider something else next time. I’m very sick and he’s telling me to go away for three months and then come back to buy yet another “consultation”.
At the last “consultation” with these doctors, they tell me that they’re no longer interested. Not quite so directly, but that’s certainly the essence of the conversation. But I still have to pay for the consultation. Medicine must be the only business in this country where you can charge a customer for telling them that you’re not interested. I can not imagine behaving that way in my profession. As a Systems Engineer in telephone and computer networks, imagine that I was called to a fault with the computer network at a hospital. I spend 30 minutes doing all the usual tests with no result, then leave to go to the next customer, leaving the hospital with a malfunctioning computer network. But they still have to pay $285 for the “consultation”. Now imagine the hospital calling numerous ”Consultant Systems Engineers” one after another for 15 years, with no result. If I behaved the way that doctors do, I’d be up before some licencing authority or other quick smart. I’d certainly find myself in court. But every doctor in this country gets away with that sort of behaviour every single day.
Interestingly, I’ve noticed over the years that more and more doctors are including the word “Consultant” in their title on name-plates, business cards, letter-heads, etc.. The last few doctors that I’ve seen: Consultant Immunologist, Consultant Respiratory Physician, Consultant Physician, even a Consultant Dietician. Is this a deliberate attempt to not take responsibility, to just “consult”. to sell “consultations”? Maybe you can’t be sued if you’re just “consulting”?
I wonder sometimes if I could actually describe this as pseudoscience, as it does not adhere to any appropriate scientific methodology. It’s a business practice given the appearance of the scientific method, to impress the paying customers.
(Edit 2nd Nov 2011)
In the medical profession, a Consultant is a senior, experienced doctor who is available to give advice to less experienced doctors. However, from my forty years experience in dealing with the medical profession, it seems that all doctors have fallen into this “consult” mindset and they all adopt this approach even when dealing with patients. I have never met a doctor who will take overall responsiblity for finding the underlying cause of a patient’s health problem.