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John Kieffer, MD MPH's avatar

Definitely need to lose the middlemen in medicine.

Jim StClair's avatar

Typical of healthcare - conduct a study showing significant ramifications on measuring care quality and steering health policy, bury it behind a paywall to limit public availability.

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Apr 7, 2023
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Apr 7, 2023
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John Kieffer, MD MPH's avatar

Kofi,

I would respectfully disagree. Yes, we need middlemen in some cases such as catastrophic events but even then, Samaritan Ministries and CrowdHealth, among others, have proven we do not even need insurance companies.

Further, the robust presence of direct care practices all throughout the US and those entities such as the Surgery Center of Oklahoma are evidence that a middleman in medicine is not necessary. Unfortunately, for the billions of dollars and livelihoods that exist as middlemen administrators, they are not likely to admit that their position is not needed.

Jim StClair's avatar

Good discussion, Kofi and Thomas. Also this analysis of PROMs is specific to an MSK practice. Is there something in MSK that makes PROMs less useful? How do we extrapolate?

I think under any circumstances where patients or customers are providing 68% of the time and it's just ignored means something needs to be re-evaluated.