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Isha Mukherjee

Mr. Speice

ISM I

11 November 2020

Medicine and business, a love hate relationship

Assessment 7 - Interview

Name of Professional:​ Dr. Kathleen Stokes

Title: ​Doctor of Pediatrics

Company: ​Frisco Pediatrics

Date of Interview: ​11/05/2020

Works Cited:

Stokes, Kathleen. Personal Interview. 05 Nov. 2020.

Assessment

Medicine is the science of diagnosing, treating, and preventing diseases. Business on the

contrary is the practice of making a living through commerce. It has long been argued that

insurance companies and medicine do not correlate therefore should not be interconnected. The

purpose of my second interview was to get a pediatrician's perspective on medical insurance but

I ended up gaining a lot of insight into how great of an influence corporations have over

healthcare.
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It is no secret that first world countries can more effectively treat illnesses than third

world countries, but I was unsure about why. Economics evidently plays a large role but it can

not be the only factor. Doctor Stokes explained to me how in the United States children most

commonly suffer from stomach viruses, vomiting, diarrhea, head colds, and ear infections;

whereas, in third world countries the most prominent diseases are measles, mumps, rubella,

chickenpox, hysteria, tetanus, and whooping cough (Stokes). In the United States, a patient with

measles or rubella is practically unheard of due to the availability of vaccines, yet yearly over

100,000 measles related deaths occur worldwide which implies that these deaths are taking place

in third world countries. This makes sense to a certain extent. Most things in life are like a

business, including medicine. For example, lots of effort and science goes into creating vaccines.

Companies then buy these vaccines and sell them to doctors. Doctors administer the vaccine and

get paid through the copay and insurance companies. The above events are a long chain of

transactions. The reason I mentioned transactions is to explain how by the time a vaccine reaches

a patient, its price is quite high. In third world countries who already lack money, acquiring these

injections would be very expensive. Especially because they have such high volumes of people

in need. In my original work, I need to address this issue because it is only getting worse. Lots of

money will initially need to be invested to help eradicate these diseases, but much like the United

States, in a few decades, there will be significantly fewer measles and rubella cases which will

warrant fewer injections. Having so many contagious and severely ill citizens only withholds a

third world nation from developing.

Another question I had was whether you had to be a pediatric surgeon to work in a

hospital. Dr. Stokes explained how hospitals employ both surgeons and pediatricians. The

surgeons only operate while the pediatricians do most of the patient care (Stokes). She also
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talked about how private practices are rapidly declining, which initially confused me. When

someone gets sick but not severe enough to warrant hospitalization, where would they go? After

much thought, I came up with my best guess for what the future of private practices may look

like. First, I think this decline of private practices has to do with larger companies buying out

small practices to make greater profits. Dr. Stokes slightly alluded to this. If this is true then it

will be much harder for a regular physician to open up a private practice and still make money if

big hospitals such as Baylor start opening up pediatric offices. From a business perspective, I

assume the incentive for larger businesses to do this would be to create a medical monopoly of

sorts. If a patient needs hospitalization or extensive care they will be referred to the parent

hospital which optimizes profits. From a patient's perspective, there is no benefit of going to a

physician owned practice versus a company owned practice. The only benefit would be the name

value. An outsider may feel more comfortable going to a branded practice rather than a

physician-run office. This will lead to a decline in medical offices but not eradication. With

fewer clinics but many patients' wait times will likely rise as well as prices. I do not think jobs

will be that badly affected because pediatricians will work for the company-owned practices.

Sadly, they will have to let go of a lot of the autonomy that being a practice owner gives them. A

concept that keeps reemerging is the idea of larger businesses imposing on smaller practices.

This same trend is seen when looking at insurance.

Going into the interview I knew that insurance companies have become very

profit-oriented by increasing premiums and copays but I had not thought about how doctors were

being affected by these companies. Dr. Stokes explained how doctors are getting their

reimbursements cut back yearly and healthcare costs are increasing, but doctors are not the ones

making the profits (Stokes). As much as it affects pediatricians, who already make relatively less
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money, low-income families are the most negatively impacted by the higher expenses. The only

solutions I see for this problem would be to convert to government-funded plans, reform private

insurance, or pass a bill that prevents insurance companies from abusing the system to make a

greater profit. The latter seems the most unlikely because it is unconstitutional for the

government to meddle in private companies if they are not doing anything outwardly bad. Going

the government route would be what Dr. Stokes refers to as "socialized medicine" (Stokes). She

condemns government involvement but personally, my previous research shows that it may be a

better alternative. Canada, for example, has universal healthcare and it is incredibly popular.

Practically no families go bankrupt due to medical bills, an increasing problem in the United

States. This would be very beneficial to low-income families. Like most things however this

system has drawbacks in that doctors make less, there are longer wait times, and slightly lower

quality care. The lower quality care is not bad enough to be a problem and doctors would make

less income which is adjacent to what is currently happening with private insurance, but in this

system, more people receive care and lucrative companies will not profit off of the vulnerable.

However, if we were to stick to private insurance it would be in the best interest of all people if

more doctors were involved in the process of setting prices, thus making insurance less

profit-oriented and more equitable. In a perfect world, insurance companies would be run

primarily by medical personnel rather than businessmen.

As we can see, medicine is deeply rooted in business, therefore reforming the system

means minimizing businesses' influence. What is unique is that in third world countries the lack

of businesses seems to be the problem. If large corporations were to set up offices in poorer

nations, the countries would make more money and more people would receive medical care.

This however most likely will not happen because these companies have proven themselves to be
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very profit-oriented and poorer nations do not have much to offer. Even if the United States

implemented universal health care I doubt that these companies would move to Africa or India.

Notes

Dr. Stokes Interview Notes