Healthcare problems

I visited the hospital earlier this week. I injured my fingers after tripping and falling over while running outside, and two of my fingers were in pain and swollen following the accident. Rather than wait it out, I decided to see the doctor.

The doctor identified that one of my fingers was broken and recommended that I undergo an operation to fix the fracture. Without going into specific probabilities, he shared that there was a good chance that the fracture would heal itself, but that he was recommending an operation to be on the safe side. He also shared that, if I decided to undergo the operation, it would need to be done within a week as it’s easier to operate on a broken finger than a partially healed one.

After hearing this information, I had two questions. What’s the doctor’s track record in correctly diagnosing the need for and correctly performing such operations, and what’s the price of the operation?

In most sectors, you know what you’re getting and what you’re giving. A product has consumer reviews and a price. This isn’t the case in healthcare.

Although there are doctor review sites, including our investment Doktorsitesi, the reviews at these sites only share what patients thought about a particular doctor. These reviews largely reflect how comfortable the doctor made the patient feel rather than the accuracy of the diagnosis and the success of the subsequent treatment.

In light of my specific circumstances, the reviews that I want to see include the fraction of a doctor’s visits where he recommended an operation (including how this figure compares to that of other doctors in the same role), and the success rate of the operations he performed. The first is a proxy for the correct diagnosis of the need for an operation (sometimes doctors recommend operations even though the patient doesn’t need them in order to earn more money), and the second is a proxy for the doctor’s abilities. Doctors and the hospitals that they work for have this information but they don’t share it with patients.

Getting information about the price of an operation is equally challenging. I asked my doctor what the price of the operation would be and he directed me to his assistant. I asked his assistant who directed me to the hospital’s administrative staff. The hospital’s administrative staff asked what percentage of the price of the operation will be covered by my health insurance. When I shared that I don’t know, they followed up with two potential prices for the operation.

The first price is if my insurance covers 100% of the operation, and the second is if I need to pay out-of-pocket. The first figure is higher than the second. But I wouldn’t be surprised if the first figure is just a headline number shown to the patient and the insurance company actually has a separate agreement with the hospital whereby it pays a lower price for the operation. I think you get the picture.

Our health isĀ our most important asset. But when it comes to making buying decisions for our health, we don’t know what we’re getting, it’s very challenging to find out what we’re giving, and what we’re giving reflects our ability to give rather than the quality of what we’re getting. These are all problems to be solved.


Also published on Medium.