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Thursday, May 19, 2016

The smell of bacon...

I am forced to attend one of these mandatory continuing medical education (CME) events. My malpractice insurance provider has a deal with the state medical association. To get lower rates, I have to be a member of the association and every 2 or 3 years attend a risk management training session.

I make it on time, despite the traffic.

As I walk into the lobby of this rather nice building, looking for signs directing me to the room where the training will be held, I am struck with … the smell of bacon.

"Please tell me that smell is coming from some other entity renting a meeting room or something," I think to myself. There are mounds of bacon and eggs next to the entrance to our meeting room.

I find a place in the back and take a seat. A well-dressed lady walks in, finds a seat in my row two chairs down, and loudly proclaims, "Is that bacon I smell? That is wonderful! We got it." In the quiet room, it is like a proclamation. Apparently she had some kind of input on the menu.

There is a whispered conversation going on between two providers in front of me. They are apparently talking about vegetarianism. The lady is not eating. The man indicates he thinks it is a good thing that there is a trend toward less meat, but he is not vegetarian. Plate after plate of bacon and eggs comes into the room.

We begin our advanced risk management training. The room is finishing the supplied "advanced risk" high saturated animal fat and cholesterol breakfast managing further disease-causing inflammation, plaque build up, and carcinogen load. We are introduced to the 3 speakers/panelists up front and 4 to 5 insurance company people sitting around me, including the well-dressed bacon lady. The course is presented by a retired doctor and an attorney.

"Why are all these other highly-paid insurance company people here?" I am asking myself. We have 34 attendees to 8 staff. I feel like I am stuck in one of those "How many really un-smart people does it take to screw in a light bulb?" jokes. Except these are all really smart people.

Is this why health care is so expensive? Wasteful pork belly systems that control and make up the bigger wasteful pork belly system? I feel badly for my patients paying for all this fat (and myself).

During the break, I lean over and offer a few helpful suggestions to the bacon lady, as she seems to speak for the insurer and course. Her half eaten plate of now cold bacon sits next to her can of Diet Coke. I offer a few suggestions about how to make the course and message more effective, and actual use of their material much easier for the user. She expresses that she thinks they are great ideas. But she doesn't sound like they will see the light of day. I speak to the bigger underlying issues creating patient risk in health care: 1. Healthcare workers are overloaded, and the level of busyness makes quality nearly impossible; and, 2. The reams of ever increasing paperwork and bureaucracy resulting in treating insurers and checklists instead of patients. This is what root cause analysis of bad events at hospitals is for, I am told. I am stunned.

The irony of what my state medical association spends resources on does not escape me. We have been trying to work with them for close to a year to utilize one of their advertised services of helping other organizations become CME providers. We want to teach doctors and all providers how to use nutrition and the rest of lifestyle as primary treatment like multiple national guidelines call for: to treat the cause of disease. We have been put off and postponed over and over and over again. I wonder how much the association gains financially from their business relationship with the insurance company and the "mandatory" requirements imposed on those insured to boost their membership numbers.

Why did I have to take time away from productive medical care? Drive an hour into the city? At rush hour? To take 2.5 hours (not counting the hour drive each way) to cover what could easily be covered in 1 hour? Why do I have to pay insurance premiums to pay 8 highly paid people to do the work of 1 to 2? Why couldn't I just review material and answer questions on the internet? At my own pace? Why don't they spend all this money to create a few simple resources that would be way more useful? It is not about patients or providers. It is big business. I don't think it is all a grand conspiracy, like some pontificate about. It is just many big businesses controlling and managing their turf to maximize fat profits. Because they can. Until we change it.

We use our little live survey clickers to answer some questions and see real-time results from the group up on the screen. Everyone is enduring. We are finally dismissed. Our CME certificates have been efficiently prepared ahead of time and are ready for pick up on our way out. The mandatory course evaluation paperwork is dropped in the pile. Everything gets top marks. We strained gnats for 2.5 hours while swallowing camel bacon, but the presenters knew their legal stuff and covered what they were supposed to. While we committed nutritional malpractice.

Our health care system Titanic sails full steam ahead into disease care Armageddon. The dining hall is filled with the smell of bacon. Health and caring be damned.

http://www.kevinmd.com/blog/2016/05/the-irony-how-my-state-medical-association-spends-resources.html

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