I have a new least favorite commercial. If you watched the Super Bowl last year you might have seen it. The segment shows a man suffering from OIC (opiate induced constipation) and suggests he ask his doctor for help. Here is the catch. The ad, costing millions of dollars a minute, sells a treatment for a medically induced condition (prescription narcotics).
Please don’t misunderstand me. Pain, particularly chronic pain, is a disabling condition. As healers, we are committed to relieving pain. However, in our world of instant gratification where technology can solve all problems, options for care are not treated equally. As a provider you can go broke talking to patients. Further, patient satisfaction scores have become one of the key metrics rating hospitals and providers; these scores may be tied directly to administrative bonuses. This double whammy creates a perfect storm. The quick fix—giving the patient a pill—is rewarded, while the hard work required for durable cures is not. Ironically, in a study of over 50,000 patients there was an inverse relationship between patient satisfaction and mortality.This response is not limited to pain management. Type II diabetes, a national epidemic, has a myriad of pharmacological choices. However, weight loss, typically the best first option, has no real market champion. There were no commercials for wellness or behavioral health services featured during last year’s half time.
Americans have grown accustomed to instant gratification—to solving every problem with a quick purchase. We make choices based on our responses to easy promises, not on careful deliberation. It makes sense that patients expect a pill for everything. However, healthcare is not so simple. Many treatment choices have unexpected consequences. Layering treatments on complications rather than addressing the root cause of problems borders on the absurd.
How do we fix this? In our capitalist society, we get what we pay for. In some sense both the doctors who prescribe drugs and the patients who take them have an addiction—in this case, to the quick fix. If we want something different, we need to start paying for the hard work (behavioral health services, wellness, preventive services) at rates comparable to technology-laden services. This may sound strange coming from a radiologist, but as an American, it’s the right thing to do.