The Jazz.com Blog
August 11, 2009 · 0 comments
Sometimes the music world has a solution to share . . . and not just a problem. Everyone is complaining that healthcare represents a growing percentage of the GDP, and that this trend will be disastrous if it continues unabated. To fix it, I propose imitating a business model that has proven its ability to shrink its share of the GDP—and do it every year. Look no further than the record industry.
To help you understand how this works, I have imagined a world in which music industry execs managed our healthcare system. T.G.
When the doctors started getting better and better looking, everyone was happy—at least at first.
“He looks so dashing in a white coat,” said Aunt Tillie when she came back from her colonoscopy. “And what lovely hair! He reminds me of that nice George Clooney in the movies. . . . . I do think I will need a follow-up appointment.”
The deans at the medical schools, who had been paying close attention to the appearance of their candidates for admission, were delighted. At first, the modeling portfolio (required with every application) was only a small part of process—and dwarfed by grades, MCAT scores, letters of recommendation and such. For a while the doctors were better looking, and still knew a smidgeon about medicine. But that didn’t last for long.
Gradually, schools that bent the rules got the more glamorous students. The turning point came when Yale and Johns Hopkins—on the same day—announced that MCATs were no longer required for admission, and hardship cases could get early acceptance without having completed an accredited pre-med course. “That next year,” griped an anonymous dean at a Midwest med school, “the Yale entering class looked they were ready for a bloody photo spread in Vanity Fair.”
Many medical practices refused, at first, to hire these glamour docs. But resistance gradually disappeared. Payola scandals sometimes made the newspapers, but usually went unreported. The head of one independent “placement agency” was heard to boast: “I have connections at the 100 largest practices in the country. With the right combo of payoffs, hookers and drugs, I could get Paris Hilton appointed as head neurosurgeon at the Mayo Clinic.”
Even back then, demand for healthcare was starting to decline—slowly at first, and then with increasing speed. Critics of the industry pointed to rising mortality figures and other gloomy statistics. Few members of the general public paid much attention to these numbers, but everyone had heard anecdotes about patients refusing to have a much-needed operation when they saw that their surgeon looked like Tom Cruise in Risky Business. Even the dumbest patients seemed to figure out that their doctors couldn't spell the names of their ailments, let alone cure them.
The American Medical Association conducted a comprehensive study, and discovered the root of the problem. “People are using the Internet to bypass their doctors,” a spokesperson announced at the press conference. “They are researching their medical conditions themselves, and self-diagnosing.” The relentless violation of intellectual property horrified the medical establishment. Patients were accessing databases, downloading documents, even checking out double-blind clinical studies from medical journals no layperson should ever be allowed to see.
“This has got to stop,” the medical professionals all agreed.
The general public didn’t take the AMA’s threats seriously at first. But when eight senior citizens in a retirement community were sued, and forced to pay a settlement of $2.9 million—for downloading extracts from the Physicians' Desk Reference off the web—people knew that the docs were playing hardball. Just two weeks later, a spinster in Minneapolis was taking away in handcuffs for having pdf files of three issues of The New England Journal of Medicine on her hard drive.
But, strange to say, the patients did not go back to their doctors. The medical industry now pulled out all the stops, and built their strategy around the three L’s—litigating, lobbying, legislating. But healthcare demand continued to decline each month, each quarter, each year. Lawyers were now calling the shots in the medical field. “I should have gone to law school instead of medical school,” doctors were heard to grumble. “Then maybe I would have some influence at this damn hospital.”
Focus groups were held, and revealed that the general public had no sympathy with the beleaguered doctors. “I would rather take out my own appendix than go to one of those bimbos in white coats.” “Giving a scalpel to that idiot is like letting a German Shepherd drive a schoolbus.”
To boost their image in the public eye, the medical establishment pulled out all the stops. A high profile reality show, American Intern, was even launched on the Fox network. Aspiring doctors selected at auditions held around the country competed, performing a different procedure on camera every week, with only the best ones surviving to compete again on the next episode. (The best interns, that is; the number of patients surviving to the following week was a secret zealously guarded by the network.)
Ratings went through the roof. But, strange to say, even the most devoted fans seemed reluctant to volunteer to serve as patients on the show.
Medical schools redoubled their efforts. Deans of admission who had served valiantly for decades were fired summarily and replaced with pimply 17-year-olds who “had their fingers on the pulse of the youth demographic.” Medical knowledge was now a liability in these institutions, and even a rudimentary grasp of organic chemistry was enough to get you demoted or dismissed. But the faculty and students had never looked better. Even so, healthcare demand continued to drop.
Finally the profession gave in, and set up their own online alternatives. “Download your own medical degree and treat yourself,” their pop-up ads proclaimed. “It’s not as profitable as the old ways of doing business,” one mogul told the New York Times, “but you can’t fight progress, huh?”
This blog entry posted by Ted Gioia