Healthcare is an ever-evolving field, with new research and advancements emerging every day. However, many patients are not aware of the life-changing medicine and treatment options available beyond traditional healthcare. After years of witnessing this alarming gap in awareness by patients and consumers, Boulder Longevity Institute’s CEO, David Van Bussum, coined this phenomenon “the market conspiracy of healthcare.” This concept refers to the factors in the market that conspire to keep the consumer from being aware of the options beyond the commonplace and standard narratives.
Physician Education
One of the major issues contributing to this conspiracy is that most physicians are not aware of the latest developments in medicine. A combination of factors including time, money and prioritization often leads many physicians to never receive additional education beyond the required Continuing Medical Education (CME) and the echo chamber conferences that they attend. This means they may not be equipped to offer patients the latest medical advancements.
According to an analysis of the 2019 Accreditation Council for Continuing Medical Education Annual Report, which accredits organizations that provide CME, physicians only made up 47% of participants in CME activities [1]. Furthermore, while physicians may participate in CME, they may not engage in self-directed learning or continuing professional development beyond what is required for licensure.
Additionally, the baseline curriculum for many doctors in medical school is often based on the legacy information that has been tried and true for decades; oftentimes not including critical aspects of preventative health. A study published in the Journal of Graduate Medical Education found that only 27% of responding US medical schools “provided the minimum of 25 hours [of training in nutrition] recommended by the National Academy of Sciences in 1985”. [2]
Overall, these studies suggest that while physicians may participate in CME, they may not necessarily receive additional education beyond what is required, and there may be gaps in their knowledge and training in certain areas.
Time With Patients
Even if a physician is aware of these advancements in science and medicine, they often have very limited time during appointments to discuss complex medical treatments with patients. On average, physicians have less than 20 minutes to talk to patients during an appointment (much of which is spent on documentation). This is not enough time to explain the complexities of new medical treatments, understand the full history of a patient’s condition, and provide the relevant understanding and research for the patient to make an informed decision.
A study published in the Journal of General Internal Medicine in 2016 found that on average, physicians only spent 27% of their total time in direct contact with patients. The study also noted that physicians spend a significant amount of time on documentation and other non-clinical tasks during the patient visit, reducing the actual time spent interacting with patients. [3]
Another 2020 study involved data from 100 million patient encounters in different health systems and measured the amount of time spent on different tasks, including direct patient care, chart review, documentation, and communication with other healthcare providers. The study found that physicians spent an average of 16 minutes and 14 seconds per patient encounter, with documentation, charting, and ordering taking up 74% of the time. [4] This suggests that physicians may have less than 5 minutes of uninterrupted time to talk to patients during an appointment, depending on the individual physician and the nature of the encounter
Insurance Companies
The third issue is insurance coverage. Insurance companies typically only cover standard of care, which is often 10 to 15+ years behind the latest research. This means that even if a physician is aware of the latest medical advancements and wants to offer them to patients, insurance may not cover them.
An article published in the Journal of the Royal Society of Medicine, Morris, Wooding, and Grant explores the “time lag” between the initial discovery of a medical innovation and its widespread adoption in clinical practice. The authors estimate that it takes an average of 17 years for a new medical technology or treatment to fully integrate into routine clinical practice, despite advances in technology and medical research. The article discusses various factors that contribute to this lag, such as the time required for clinical trials, regulatory approval, and changes in medical education and training. The authors argue that reducing these time lags is essential for improving patient outcomes and maximizing the benefits of medical research. [5]
As further evidence, according to “Medicare Coverage of Innovative Technologies: The U.S. Should do More to Speed Entry of Breakthrough Devices to Market” by Grogan (JD), published in 2021, new medical technologies and procedures are adopted slowly by Medicare, with it taking an average of 4.5 years for approval and coverage from Medicare. The provided example was a medical device for HIV patients that took 67 months before being covered by Medicare services. [6]
Liability
Lastly, physicians face liability risks if they offer new medical treatments without the necessary credentials. With many new treatment modalities falling under the umbrella of Functional or Cellular Medicine, unless a physician is board-certified in both their specialty and a secondary functional medicine specialty, they face the risk of being sued if anything goes wrong. This risk of liability means that physicians may be reluctant to offer new medical treatments.
All of these issues combine to create a market conspiracy that is keeping the general public from learning about the latest medical advancements. However, Boulder Longevity Institute and other leading experts in functional, regenerative and cellular medicine are advocating for change. They believe that by raising awareness and advocating for more education and research into this field, insurance companies will be more likely to cover new medical treatments.
In conclusion, it is important for patients to be aware of the market conspiracy of healthcare and to advocate for change. By working together, we can break down the barriers that are keeping us from the medicine of the future. It is time for patients to demand access to the latest and most innovative healthcare treatments.
References:
[1] Analysis of ACCME 2019 annual report data. AOE Consulting. (2020, August 19). Retrieved March 30, 2023, from https://www.aoeconsulting.com/cme-news-item/analysis-of-accme-2019-annual-report-data/#:~:text=Of%20total%20attendance%20at%20CME,53%25%20were%20non%2Dphysicians.
[2] Adams, K. M., Kohlmeier, M., & Zeisel, S. H. (2010). Nutrition education in US medical schools: latest update of a national survey. Academic Medicine, 85(9), 1537-1542. https://doi.org/10.1097/ACM.0b013e3181eab71b
[3] Sinsky C, Colligan L, Li L, et al. Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. J Gen Intern Med. 2016;31(6): 591-597. doi: 10.1007/s11606-015-3488-3
[4] Overhage, J. M., & Jr. McCallie, D. (2020, February 4). Physician Time Spent Using the Electronic Health Record During Outpatient Encounters: A Descriptive Study: Annals of Internal Medicine: Vol 172, No 3. Annals of Internal Medicine Journal. https://doi.org/10.7326/M18-3684
[5] Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med. 2011;104(12):510-520. doi:10.1258/jrsm.2011.110180
[6] Grogan, J. (2021, September 23). Medicare coverage of innovative technologies: The U.S. should do more to speed entry of breakthrough devices to market. USC Schaeffer. Retrieved March 30, 2023, from https://healthpolicy.usc.edu/evidence-base/medicare-coverage-of-innovative-technologies-the-u-s-should-do-more-to-speed-entry-of-breakthrough-devices-to-market/#:~:text=As%20of%202019%2C%20securing%20regulatory,completed%20in%20about%20eleven%20months.
