Regrettably, it must be acknowledged that our healthcare system is currently facing significant challenges. Over-servicing in healthcare is rife and exposes people to inconvenience, fear avoidance, excessive costs, and potential harm.
Firstly our healthcare system is a fee for service model, which means health care providers generally only get paid when we build returning customers in private practice. Staff leaving work to turn up to appointments with a Doctor, consultation over in 2 mins with no real plan, this is a thing of the past.
We won’t get you bogged down looking at this lack of value, let’s list a few things to think about in the over servicing model in healthcare.
Health Care Culture
“More is better” and “Let’s get a scan” along with the messaging from pharmaceutical and device companies around quick fixes and new treatments ultimately create a trap for a consumer. A trap which sets individuals on an overuse quick fix conveyor belt.
Google “why is my back sore?”…….
And you will see a top ranking article, 27 possible causes of back pain. Does this help someone or does it create fear and a culture of trying to find out what’s wrong?
Entering into a fee for service system that has no reward for a successful outcome.
An analysis of knee pain on the internet found only 6 of the 93 documents cited research, mostly sensational claims about new treatments and the we will fix you approach to health care. Which, in musculoskeletal medicine should be a warning sign to a consumer. Marketing and the bombardment of information impedes informed choices about injury management and perpetuates blind faith in the health care practitioner or care.
The Patient NEEDS
“Can you just massage my neck?”
“My doctor says I have knee arthritis, so I don’t want to exercise and wear it out”
“I have impingement in my shoulder, I can’t use it because I will tear my tendon”
As a healthcare practitioner, I have heard and seen it all. Quoting a paper from 2020 “Patients often overestimate the benefits and underestimate the downsides of health care.” People with knee arthritis think they will get greater benefit from injections and medicines compared to exercise. BUT the research is 100% opposite to this.
Patients often choose surgery when there are other pathways, overestimating the “cure” for their pain and definitely underestimating the role of rehabilitation and life challenges will have post surgery. EG: Shoulder surgery to “fix” a partial or full thickness tear of a rotator cuff tendon has been shown to have a failure rate of 33% and 75% of those happen with no trauma and they still get better!!! (Kluger)
Low health care literacy has also been associated with unnecessary health care use.
Time constraints.
In a fee for service model, time is money, this becomes a problem when communication in healthcare is vital to success. It costs us too much and we don’t have the time. We should demand more!
Defensive Medicine.
In some healthcare models, practitioners may over-service to avoid potential legal repercussions, even if not clinically indicated. EG: Let’s just get a scan just to be sure.
Lack of Awareness or Training.
Some health professionals may not be fully aware of the latest evidence-based guidelines or may not have updated their training for some time.
It’s what we do here.
There are some real challenges in health care models, we know things need to change, so do you.
Current recommendations now demand that advice and treatment for musculoskeletal conditions should be delivered by Physiotherapists as the front line practitioner.
At Health Stack we work with organisations around the nation, building resilient staff through our industry proven injury management and workplace programs. We have treated over 20 000 staff around Australia, reducing and managing workplace injuries with a focus on improving physical and mental health.
