“Somewhere in the United States at this moment, a patient with chest pain, or a tumor, or a cough, is seeing a doctor. And the question we have to ask is whether the doctor is set up to meet the needs of the patient, first and foremost, or to maximize revenue.” This is the overall question posed, discussed, and answered in this article from The New Yorker.

Economists have pointed out that a key problem in our system of healthcare is that doctors are paid for quantity, not quality, of services. They are also paid as individuals with varying rates they can determine themselves, instead of as members of a team who work together.

The Cost Conundrum takes a deep dive into why healthcare is so expensive. The author explores behaviors of doctors and patients in different parts of the country to establish his stance on the matter. One of his stops was McAllen, Texas, which has the most costly healthcare in the country. Medical expenses skyrocket it this small town because of an overuse of medicine. Doctors in McAllen on average prescribe more medicine, order more tests, request more doctor’s visits and overnight hospital stays, and schedule more surgeries than anywhere else in the country.

“Americans like to believe that, with most things, more is better. But research suggests that where medicine is concerned it may actually be worse.” Studies show that in areas where more money is spent on tests, office visits, drugs, and surgeries, the patients show little to no increase in survival, ability to function, or satisfaction with the care they received when compared to areas that had far less medical expenses.

The article also talks about the Mayo Clinic, which has created a reputation for itself because of its core belief “The needs of the patient come first.” The Mayo Clinic changed the relationship between money, doctors, and patients when they “pooled all the money the doctors and the hospital received and began paying everyone a salary.” By doing this, the doctors’ goals automatically shifted from how much money they could make on a patient to how much they could help the patient. How they help patients does not affect their income, which allows them to work without alternative motives.

According this article the best solution for reduce outrageous healthcare expenses is for doctors of different specialties need to collaborate to increase prevention and quality of the care. Many doctors may work with the same patient, but because they all work individually and charge individually, the patients’ problems are not solved together. Rather it becomes a disjointed effort with endless bills and office visits. Having an every-doctor-for-him/herself attitude is fostering self-interest and over-spending.

This article invites readers to decide between the McAllen model and the Mayo Clinic for the future of our healthcare practice.