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The right time to drive out the ‘medical industrial complex’

January 29, 2015

By Margie Coloian

“The driving principle of medicine is revenue generation,” says Diane Meier, MD. “And the patient is a means to that end.”

What has happened over the last one hundred years, according to Meier, is that science has created more specializations in medicine and that, coupled with employer and government based healthcare coverage, has boosted the “medical industrial complex. Patients don’t come first; everything is driven by the medical industrial complex.”

Even so, says Meier, director of the Center to Advance Palliative Care, Mount Sinai Health System, there is still hope for revamping medicine, and the time is right. With the implementation of the Affordable Care Act, she says, “we are moving away from fee for service toward what’s in the best interest for the patient. And there are opportunities now to bring care to the home and community settings versus the emergency department.”

Meier is considered one of the founding mothers of palliative care, a growing specialty, which has a critically important role in ensuring that seriously ill patients get truly cared for. The World Health Organization defines palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”

The widespread implementation of palliative care has sometimes been hampered by misperception. Often, palliative care is confused with hospice, even though it can be administered at any stage of illness, not necessarily at the end of life. “Some doctors don’t understand what palliative care is and because of this, their patients are denied this supportive service,” says Meier.

In this video, titled Palliative Care and the Human Connection: Ten Steps for What to Say and Do, Meier eloquently explains some of the challenges facing patients (and doctors) at the end of life or for other conditions where palliative care is beneficial.

Meier has been recognized numerous times for her creative and dogged leadership. She is a recipient of the MacArthur Fellowship (“genius award”) for individuals who have shown exceptional creativity in their work and the promise to do more. And she is one of the great keynotes at the third annual Lown Institute conference, Road to RightCare: Engage, Organize, Transform, in San Diego, March 8-11.

Meier says she is looking forward to the conference. “I hope the conference leads to greater clarity of a positive vision of the good—not more admiring of the problem,” she said, referring to overtreatment and under-treatment. “How bad is the system? Let’s just leave that behind.”

What does she envision for a better system? “We need a balance in healthcare,” she said. “We need greater population health, more patient-focused care, decreased spending on healthcare and protection from overtreatment and under-treatment.”

After developing a good visualization of what a great healthcare system will look like post conference, Meier suggests communication with the public should be the next step. “We have a public that believes that we have the best healthcare system in the world. We need to give them a competing vision of what our future vision is for healthcare.”

You can hear Meier’s talk and those of other great keynotes at the conference. If you have not registered for this amazing meeting, please do so now. Space is limited, and registration closes on February 10.