Another cost driver is the high end medical practice buildings popping up all over our town. These buildings are not basic. High ceilings, huge waiting rooms, trim detail, artwork, and high end furniture. These buildings cost a lot to build, maintain, heat and cool.
I remember when I came to town and started with a practice 30 years ago. The doctors were young, the practice was in a cramped, rented, older office building, the exam rooms were tiny, the waiting room had a linoleum tile floor, and the furnishings were Spartan. Fast forward to today and the same practice is in a palatial custom built freestanding clinic the doctors built and rent back to the practice, no doubt with a high margin. Lots of architectural detail, lots of wasted space, expensive executive level furnishings.
Not to mention the two receptionists who once did checkins and checkouts as well as administrative tasks are now a staff of 8 clerks, 4 dedicated receptionists, and a full time office manager. In the old days the paperwork was hand processed, today it is all electronic. The doctors walk into the exam room accompanied by a scribe caring an iPad. The doctor also carries a laptop from which she views my medical record. During the exam, the scribe takes notes and at the end of the consultation pushes a button. Outside the exam room the scribe retrieves the bill from a printer, hands it to me, and sends me to the checkout desk.
The quality of my healthcare is the same as it was when the doctors were in a very basic, low rent location with a skeleton staff and one desktop PC. Actually the quality is probably less since the formerly 20 minute appointments now are 10 minutes and if I don't schedule the appointment more than two weeks in advance I'm likely to see a physicians assistant or nurse practitioner instead of an MD.
Don't even get me started on the local hospital where the construction crews are ever present building new and ever more luxurious additions and patient rooms during an era when more and more surgical procedures are being done on an outpatient basis. Perhaps the extra space is for the expanding armies of bureaucrats and administrators who provide zero health care services.
Someone needs to value engineer the entire system to eliminate the exploding costs not associated with the actual delivery of diagnostic and care services.
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