The United States Health Care System is Sick: From Adam Smith to Overspecialization

Abstract

The United States (US) health care system is sick. High cost affects the nation and the people. The poor outcomes mainly impact the patients. If we do not fix it, the system will implode because of the unsustainable economic burden.The choice to shape the health care system on the “pin factory” model described by Adam Smith is the cause of the failure. The key players in the health care system are accordingly molded.Many factors tightly intertwined need to be addressed. Medical education, the role of family doctor, the overspecialization and, not least, the translation of discoveries into clinical practice are among them.The failure of the US health care system is a complex and multi-factorial issue which requires a global approach.

The Hidden Curriculum and Integrating Cure- and Care-Based Approaches to Medicine

“…According to Densen ( 2011 , p. 50), “it is estimated that the doubling time of medical knowledge in 1950 was 50 years … in 2020 it is projected to be 0.2 years–just 73 days. Students who began medical school in the autumn of 2010 will experience approximately three doublings in knowledge by the time they complete the minimum length of training (7 years) needed to practice medicine.” While discovery and the expansion of knowledge is generally positive, it is important to recognize that over-specialization could result in a neglect to care for the whole person (Anderlini 2018 ; Frandsen et al 2015 ). As areas of expertise become deeper and narrower, the need for physicians to take a step back and consider a wider perspective is heightened.…”

Communication barriers between basic scientists and clinicians in regenerative medicine: A qualitative study from Iran

“…As a consequence, the desire of clinicians to further specialize arose. They found that specialization is a unique way to expand their expertise 61 . However, the World Health Organization (WHO) report in 2008 pointed out that fragmentation of care was one of the five obstacles health systems faced.…”

“…However, the World Health Organization (WHO) report in 2008 pointed out that fragmentation of care was one of the five obstacles health systems faced. Other studies revealed that the fragmented health care system in the United States accounted for one hundred million medical errors annually 61‐63 …”

“…They argued that upon overspecialization, scientific researchers disregarded any broader examination of the social roots from their inquiry. Some later philosophers, including Jürgen Habermas, have also pointed out that overspecialization might lead to distorted relationships in society 61,64 . Habermas assumed specialization as an indispensable component of modern life.…”

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