Discussion


In this week’s lecture, we studied the “Marcus Welby Medicine”(MWM) model. In MWM, primary care physicians serve as the “captain of the ship” who direct our health care system, and what separates Dr. Welby from other “sales” people is trust. In fact, as Dr. Arrow mentions in his article, “the social obligation for best practice is part of the commodity the physician sells”. Patients cannot directly measure whether the MD is trustworthy, but believes that the socialization within the medical community fosters appropriate MD motivations. 

We also learned that despite being fondly remembered as an “ideal” example of how a primary care physician (PCP) should operate, the MWM model was subject to inefficiencies such as demand inducement.

Your discussion assignment for this week is the following. 

Your initial post is due by Fri 4/15 at 11:59 pm. 

Your reply to at least one classmate’s answer is due by Sun 4/17 at 11:59 pm. Your reply can elaborate off the initial post, provide further examples based on the initial post, provide anecdotes or offer suggestions to your classmates based on your own experience.

Topic: Marcus Welby Medicine in the 21st Century

Step 1: Read Dr. Arrow’s paper to review the MWM model: Wk10_Arrow.pdf Download Wk10_Arrow.pdf

Step 2: Answer the following questions. 

Today, technology has changed everything. Individuals now buy drugs on the Internet and Tweet about their latest visit to the physician office. They can rate their doctors on healthgrades.com. They can research their own illnesses through websites such as WebMD.com and MDAdvice.com.* The recent development of Health Information Technology (HIT) such as Electronic Medical Records (EMR) could help prevent medical errors and exchange patient information among healthcare providers. Moreover, during the current pandemic, the use telemedicine has been expanded to ensure access to essential health services. (See CDC guideline for telehealth services during COVID-19 pandemic: https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html (Links to an external site.) 

How might you harness modern technology to transform the role of the primary care physician, creating a “Marcus Welby for the 21st Century”? (I.e., how does technology such as telemedicine, healthgrades.com and WebMD.com change the role of primary care physicians?) Specifically, how does modern technology affect demand inducement (i.e., the extent to which physicians could potentially induce demand)? 

* Note that these sites are not always a good source for determining what caused their illnesses or accurately providing a self-diagnosis. Sometimes these sites even create frustration and unnecessary worrying.