Consumerism and Convenience Gone Wild in Health Care

I have received several phone calls in the last few weeks from young adults requesting information about their last vaccinations. They are travelling to areas of the world that suggest or require certain vaccines and do not remember if they had them or not. Others are applying for positions of employment which require travel and the employer’s human resources department needs the patient’s updated vaccination records.

When we tell them that we only have a record of the vaccinations we have given them in the office they act surprised. “You mean XXX hasn’t sent you a copy of my tetanus booster shot?” Others inquire if the travel health service they went to sends us a record of the vaccines they administered. The answer is “sometimes”.

The State of Florida instituted a website called Florida Shots for immunization records a few years back which is incomplete at best. At one time you received all your vaccinations and immunizations in the doctor’s office and a record was then maintained.

In the new world of consumer convenience first, pharmacies are paid by insurers for administering vaccines while the same shot given in your doctor’s office is not a covered service. In some cases, we have the childhood vaccination records from a pediatrician and a college health form updating us on meningitis and hepatitis A and B vaccines. Those adults out of college for more than seven years who do not have a copy of that form are just out of luck. This is a prime example of consumerism and convenience gone wild for no good reason

Another example is the creation of the BasicMed program allowing non-commercial pilots to obtain a medical certification to fly instead of going to a highly trained certified FAA Airmen Medical Examiner Physician (AME). If you have a driver’s license and pilot a plane for 6 or less passengers, which will not fly faster than 250 knots, or ascend above an altitude of 18,000 feet; you can go to any doctor with your driver’s license and be certified to fly.

Why would a pilot go to BasicMed rather than to a trained and certified and recertified physician in aerospace medicine? Probably because they are concerned that the trained physician will not pass them based on their health and the non-certified doctor will either go easier on them or just miss the problems that an AME might investigate.

 

This law was the result of lawsuits against the FAA by pilots not meeting the standards and resulted in Congress passing this private pilot friendly law. In recent years, expensive private flight schools have become the pathway for a student to eventually become a commercial airline pilot. They are replacing the previous pathway of hiring former military pilots who are more experienced, more disciplined and usually older and more mature than flight school candidates. This new breed of air transport pilot will now be sharing the skies with private civilian pilots receiving their medical clearance from less physicians with less aerospace medical knowledgeable. Is this not also convenience and consumerism gone wild?

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