Suggestions to Address the Increase in Demand and Costs in General Medicine: Escaping From a "Black Hole" and from Boomerang Effect
Journal Title: Journal of Quality in Health Care & Economics (JQHE) - Year 2019, Vol 2, Issue 2
Abstract
General practice of care plays a central role in effective and cost-effective health care. General practitioner (GP) has a solid position: each resident is on the list with a GP is accessible to everyone, and GP handles most of the health problems and coordinates the referral to specialized care. But, utilization rates increase, as do their costs, and this may indicate an inefficient use of health services. The typical response is the increase in the supply of resources, which causes a "black hole" or “boomerang” effect. This article exposes the idea that the increase in demand and assistance at the level of general medicine cannot be resolved by increasing the supply of resources, but rather that the organization of medical practice and technical actions are the main causes that increase health demand, which is inefficient, expensive and iatrogenic. It is the existing trends of medicalization that increase the prevalence of the disease and its treatment, when for example, from the beginning treatment it is made with drug associations, with use of higher doses of drugs, with screening and preventive counselling that are not based in scientific evidence, etc. To avoid the increase in demand, and get out of "black hole", the hypothesis is presented that achieving a more reflexive and critical GP, who in every consultation, is prepared to understand and solve the query "in another way", in biopsychosocial terms and avoiding medicalization, and also delegating and working in a team, but keeping leadership of patient management in each clinical problem, can be a real filter for the introduction of medical measures that are little contrasted at the individual and population level, both from the clinical, ethical, quality, epidemiological and economic points of view.
Authors and Affiliations
Turabian JL*
Keywords
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- EP ID EP746475
- DOI 10.23880/jqhe-16000120
- Views 26
- Downloads 0
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