Shrinkflation in Healthcare - Less Time With Your Physician, Higher Cost

Where did your physician go?

We are all familiar to that bag of chips getting more expensive with fewer chips. The equivalent of this corporate greed in the healthcare system is less time (or no time at all) with your physician, at the same time that healthcare costs skyrocket, health insurance premiums balloon, and Americans become increasingly saddled with debt.

This is what happens when consolidated corporations - from private equity firms to hospital systems to tech companies to insurance companies - own medical practices.

Most people are surprised to learn that physicians employed by corporate entities do not even know what is being billed or collected in their names. Physicians suffer from skyrocketing rates of burnout (better referred to as Moral Injury), being placed into impossible situations by corporate employers that demand physicians and patients be treated as widgets.

Read: How Rich Investors, Not Doctors, Profit From Marking Up ER Bills

Physicians are Retaliated Against When Standing Up For Patients

When physicians oath to put patients first is at odds with a corporation's bottom line, physicians may be retaliated against - by getting fired or even having their careers ruined. This dilemma - honor our oath to patients, or risk being fired by an employer, with few other choices for work in one's community results in moral injury - a concept translated from the military to healthcare by Dr. Wendy Dean, co-founder of "Fix Moral Injury" She is also co-author of the book "If I Betray These Words: Why It's So Hard to Put Patients First"

In this video, Dr. Dean presents the concept of Moral Injury as the Keynote Speaker at the 2023 Take Medicine Back Summit

Resources for Patients

Navigating the U.S. Health System is daunting to say the least. The majority of people who are indebeted to hospitals actually have health insurance. Half of U.S. adults say it is difficult to afford healthcare costs, with one in four reporting difficulty paying for healthcare in the past year. Sixtyone percent of insured adults say they have gone without needed care because of cost.

In the United States, pharma advertises direclty to patients, and insurance companies increasingly own and control both the pharmacy benefit managers (PBMs) and the prescribers. How are patients supposed to trust their physician? Eighty seven percent of physicians surveyed in 2017 felt that patients trust them less than a decade prior. When patients do get an appointment with a physician, they are usually booked for months, and visits are rushed.

It's no wonder that one study found eighty nine percent "Google" their symptoms before going to a doctor, with fourty percent of patients turning to "Doctor Google" instead of seeing a physician at all, with the average person self-diagnosing four times per year!

Take Medicine Back finds this current situation to be completely unacceptable in the 21st Century - and it is due to Corporate Greed. But physicians are fighting back to restore the physician-patient relationship. Please find some of our favorite resources for patients below.

Find an Independent Physician - Direct Primary Care (DPC)

In the early 20th century, patients had direct relationships with their physicians. For the most part, there were no intervening middlemen. Care was relatively affordable. Today there is a growing movement to go back to the basics, make high-quality primary care affordable again, and escape the corporate system.

This movement is called "Direct Primary Care." DPC is not concierge, though it can feel like it! A central tenent of DPC is to keep costs affordable for patients, and pass along discounts on labs, medications, imaging, and procedures. You do not need health insurance to get a DPC doctor. You can also check DPC Alliance and Direct Specialty Care Alliance

Some Tips

DPC Frontier is just a starting point. It is not comprehensive, and not all practices are of equal quality.
Avoid any practices masquerading as "direct" that are actually owned by corporations. DPC does not just mean not-taking insurance - it is directly with the physician, not a corporate employer
Call the practices and ask to speak with the physician before you sign up! The physician-patient relationship is paramount in DPC. Make sure it's a good fit.
Make sure you know what you're getting! If you want a fully trained physician (MD or DO), make sure you check and ask credentials.
If you can't find a practice in your area, call some of the closest ones and ask if they know about any new practices closer to you. If not, it may be worth the occasional travel, because telemedicine is easy in DPC.
Most DPC physicians give their patients their cell phone number.

Find a DPC Doctor in Your Area

Find an Independent Patient Advocate

Bradley Schwarz, JD lost all of his limbs in a case of medical malpractice. But he understands that physicians and nurses are put in an impossible situation when under-staffed. Although he still works as a medical malpractice attorney, Bradley decided to start Greater National Advocates to connect patients to independent patient-advocates, in order to help prevent harm in the corporate healthcare system before it occurs. They have grown to include advocates with diverse expertise, from navigating the healthcare system during an medical crisis, to insurance & billing guidance, to survivor support.

Greater National Advocates

Dollar For - "Crushing Medical Debt"

This non-profit, founded by Jared Walker, works to "crush your medical debt" by holding hospitals to their charity care policies.

According to their website, "most hospitals offer discounts or bill forgiveness based on income. On average, a family of 4 earning less than $100,000 a year will qualify. We can help you apply — for free."

Get Relief from Hospital Bills with Dollar For

Always Stay Updated

Don't miss anything by signing up for the Take Medicine Back newsletter. We'll never sell your information. Physicians, healthcare workers, patient advocates, policy-makers, lawyers, economists and more are welcome.

Breaking News on Corporate Practice of Medicine legislation, policy
Make a Difference: Calls to Action
Growing resources for physicians and advocates
Updates on Non-Profit Professional Membership