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Active Learning: Find the medical subversion

Today, I am launching a new blog heading called "Active Learning." I'm ripping off the idea from a requirement we had in college wherein us wide eyed undergrads were required to step outside our comfort zone and participate in activities we wouldn't normally. (For example, my first yoga class happen back then. (Good times.) The goal is to give you opportunities to learn more about the healthcare system you're paying thousands of dollars into.

Your first assignment: before you read my commentary below, go to the following website, look around, and answer this question: "what kind of company is this?"

My impression:

This is one of the most beautiful websites I have ever seen. It's user interface is beautiful, the graphics dynamic, the animation superb.

But it's all fluff designed to misdirect you, the American patient.

The logo suggests an actual healthcare company that provides a natural and organic service (as noted by using very earthy colors like orange and green.) Their treatment pathway called "destinationwell" invokes the current trends to focus on wellness rather than illness. And they've coined an ingenious term called "personalized medication intelligence." Because after all, who wants "generalized drug stupidity?" For marketing, they get an A+.

Their impressively crafted service display lists services that sound great but aren't proven to be very helpful to the vast majority of patients:

Pharmacogenetic testing is all the rage now because patients are wondering if they're on the "best" medicines. In psychiatry, this practice is especially rampant and there is a battle brewing between providers about the validity and usefulness of the results. Unfortunately, the evidence for effectiveness for doing these screenings isn't any better than what your provider does which is provide you with their best educated guess. Of course these tests cost thousands of dollars. Companies are proud that "Medicare" will cover these unnecessary tests. But that's a slight of hand since we're paying for Medicare.

Medication monitoring has also become more common to ensure compliance with treatment planning. One of my pet peeves about wholesale medication monitoring is that it creates an adversarial relationship between a patient and a provider and disempowers patients. As I remind my patients: you can skip your medications but I'm not the police, I don't plan to track you down, nor is it my responsibility to force you to make good health choices. The standard urine tests and occasional blood tests are sufficient for certain treatment plans (e.g. drug screens for illegal substances or levels for medications like lithium.) This type of marketing fuels paranoia amongst providers that not checking compliance through a test is poor clinical practice.

Predictive analytics is another brilliant slight of hand. Your provider is trained in those analytics since that's what medical education is: culminating thousands of years of knowledge into a "best guess." Sure, computers help sift through data easier, but you don't need a random commercial product to guide your treatment planning when you have a well trained, attentive provider with the time to get to know you and invest in your care.

Please take note: I have nothing personally against this company, nor do I think they are being evil or dishonest. They are doing what they're designed to do: make as much money as possible. This is just one company amongst many who are selling a product for a solution for which there isn't a problem.

Under the PSYCH plan, companies like this will still exist (remember, PSYCH lets market forces do what market forces do.) But in the PSYCH paradigm, you'll have access to providers who can help you make the best healthcare choices for you and your family.

In the meantime, be mindful and alert to slick healthcare marketing campaigns.

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