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What the NFL Referee Debacle Can Teach Us About the Future of Healthcare

Written by Brandon Betancourt

Even if you are not a football fan, I’m sure you’ve heard about the NFL and referee fiasco.

If you haven’t heard, here is the scoop. The NFL owners have been unable to reach an agreement with the referees. As a result, the referees were locked out and the NFL owners replaced them with cheaper less experienced referees.

The result?

Although qualified to referee a game, these less than professional referees don’t have the experience, the full requirements and the practice of a professional NFL referee. Consequently they’ve made some really, really bad calls.

Some calls have been so bad, that they have cost teams games.

In healthcare, there is a lot of talk about filling the primary care physician shortages that we expect in the near future, with mid-level providers such as nurse practitioners and physicians assistance.

Mid-level providers are competent healthcare providers. But they don’t train as long as a physicians do. As a result, they have less experience. On the flip side, they’re cheaper to train, and they earn less than a physician does.

Naturally, if you are trying to reduce healthcare cost, and you are planning on having a labor force shortage, mid-level providers seem like a good solution.

Don’t you think?

I think this is a bad idea. The NFL debacle is great example of what happens when one chooses to settle for next best.

For the record, I’m not putting down mid-level providers. I think they are valued team members. If I didn’t believe that, we would have not hired a mid-level provider in our practice.

I believe mid-levels have a place in our healthcare landscape and they will play an integral role in the future of primary care. But what I’m saying is, they are less experienced. They don’t go to school as long as a doctor does and don’t bare nearly the same responsibility as a doctors do.

Here is the thing, primary care doctors are tremendously valuable. Although they may appear to be expensive to visit, when you compare it to the value they return, the cost is minimal.

Think about it this way. How much would you pay to be assured that your child is healthy? What is the value of having a person that has dedicated 100% of their professional career to learn about children so that each child can reach their full potential?

Don’t make the same mistake the NFL owners did by choosing a less expensive, quick fix solution.

I can almost guarantee you won’t regret it.

Brandon Betancourt is a practice administrator. He blogs regularly at PediatricInc

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The Joy of Practicing Medicine Outside the U.S.

Written by David Sprayberry MD

I recently spent 3 weeks serving at a mission hospital in Kenya. It was a highly challenging time, with a much greater severity of illness and greater limitation of resources than we have here, but it was the most rewarding thing I have ever done as a physician. The work I did was needed, difficult, and stressful, but I did not have to fight an insurance company once and I did not have to constantly worry about my documentation meeting the minutiae of coding regulations that, if not followed precisely, might lead to accusations of billing fraud. I was able to focus on taking care of patients who needed help without significant intrusions by insurance companies. I was able to document what was important to the care of the patient, not what the insurance company or government wants to see on paper. It was demanding and refreshing at the same time.

In Kenya, I was able to perform procedures and take care of rather complex patients because I was the most qualified person available. In the U.S., I am forced to refer patients to subspecialists for problems I can handle, because I would have great liability if a patient had a poor outcome and I had not referred them out. In Kenya, I took care of premies who required intensive care, I intubated and ventilated babies, and I set up and changed ventilators. I managed kids with severe hypoglycemia, severe malnutrition, severe dehydration, meningitis, sepsis, tuberculosis, malaria, and congestive heart failure, most of whom I would not have had an opportunity to care for here in the U.S. because a subspecialist would have had to be involved.

Despite the limited resources we had to work with and despite the heartbreaking events that occur when practicing medicine in the Third World, I must say that my experience in Kenya is why I went into medicine. It is comforting to know that I can go practice there if our government and our insurance companies ever make practice here unbearable. In fact, I could practice there now.

Dr. Sprayberry is a practicing pediatrician and believes there is more to medicine than shuffling patients in and out the door. To read more about Dr. Sprayberry’s medical trips to Kenya, visit his blog, Pediatrics Gone to the Dawgs.