Sunday, March 16, 2014

Ravings of Medical Innovation Individualistic Semi-Madman

The American system of rugged individualism.

Herbert Hoover (1874-1964)

The writer is the Faust of modern society, the only surviving individualist in a mass age. To his orthodox contemporaries, he seems a semi-madman.

Boris Pasternak (1890-1960), The Observer, London, 1959

Individualism is running amuck among the Millenial generation and among physicians.

Permit me to explain lest you think me semi-mad.

The millenials,  that generation born in the 1980s and early 2000s,  thanks in no small part to the Internet and to the online craze to be connected to other individuals,  have gone wildly individualistic.

Here is how Ross Douthat, the New York Times columnist,  lays out the individualistic scenario (“The Age of Individualism," March 16, NYT):

“In the future, it seems there will be only one “ism” – and its rule will never end. As for religion, it shall decline; as for marriage, it shall be postponed; as for ideologies, they shall be rejected; as for patriotism, it shall be abandoned; as for strangers, they shall be distrusted.  Only pot, selfies, and Facebook  will abide- and the greatest of these sill probably be Facebook.”

This state of mind has ObamaCare consequences.  Once thought to be in the pocket of Obama and the Democrats, it turns out the Millenials are reluctant to pay out-of-pocket for those average 47% increases required in  health exchange plans.  

In  millennial  minds, these plans are not a good deal, when you can’t afford them, when  ERs will have to accept you, when you can get your plan after you fall ill, and when the IRS isn’t going to be able to enforce the $95 penalty anyway. 
In the words of one millennial, Evan Feinberg of Nevada, 

We’re young but we’re not stupid...only 22% of Nevadans signing up are between ages 18 and 34, a far cry from  the 40% the White House wanted…Blame the ObamaCare marketing team.  The team’s efforts to persuade us to sign up have been inappropriate, incoherent, and simply insulting.”

In other words, we Millenials are  going to make up our individualistic  minds,  do what we want to do as individuals , not what the political establishment tells us to do.

This brand of individualism  is bad news for the Democrats since youthful voting patterns tend to persist across the life cycle.

Which brings me to the doctors as individualists.   Some independent  individualistic doctors  have this crazy idea that individual patients prefer to be treated as individuals by individual doctors,  rather than squads of caregivers governed by rules of the collective.  

 For this purpose, they have come up with the idea of direct pay, insurance free medicine, which includes concierge medicine.

Direct pay medicine may not work, but then again, it might work better than unworkable ObamaCare.   

One reason it might work,  if the direct pay doctors play their online cards right,  is the new powers made possible by the Internet,  mobile devices, smart phones,  and individualistic connection sites like Twitter,  Facebook, and similar sites.

If  direct pay doctors ( also called concierge, retainer, and boutique doctors) can unleash the following online applications (apps to the online crowd and nerds in the know),  doctors may be on to something online.

·         E-mail messaging -  why not communicate by email rather than phone or office visits,  as a regular feature of your practice.

·         Telemedicine and Skype-like visual  communications – with these online features,  one can interview,  record vital signs, heart rhythms and heart sounds, even examine a patient, without the person being there. Why not?  The technology is already there.

·         Drone delivery -  The drone industry is literally  taking off. Why not arrange online to have medical products – test kits, catheters,  prescriptions, other medications,  and so forth – delivered to the home by drones, or unmanned flying vehicles, if you prefer, or even have body fluids delivered to your office, all as one individual to another?

I’ll quit now.  I’m beginning  to rave.

Tweet:   The Internet and its myriad apps lend themselves to individualism among the young and among doctors in direct cash practices.

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