The US healthcare system confuses even the most seasoned professionals. I created this online course to introduce health coaches and non-healthcare professionals to the basics of the US healthcare. We’ll discuss some basics here, and you can enroll in the course for a better overview.
The US healthcare system is a convoluted one. Not until a few years into my career as a physician did I finally understand it. I learn some nuances of it daily.
I created this 1-hour online course to share my perspective of the US healthcare system for an audience of non-healthcare professionals. Whether you’re a medical student, a health coach, a personal trainer, or a healthcare entrepreneur, this online course is an excellent overview.
This online course comes with a 100% money-back guarantee. Pay for the course, take it, and if you don’t like it, I’ll refund your money. In return, I would love feedback on how to improve the course.
The Non-Healthcare Professional
If you’re a fledgling medical student, there is much to understand about the US healthcare system. With this information, you can decide where you’ll be most effective.
A lifestyle coach or personal trainer needs to understand the healthcare system in the US to guide their clients. If you know the available resources to patients, you can help them make better decisions.
Health coaches are a growing segment of the healthcare system. There is a considerable gap between the patient-doctor visit and the patient’s eventual health outcome.
Health coaches fill this gap by helping the patient understand what is going on with their bodies and their options to enact health changes.
The Patient Journey
In this course, I talk about the patient journey, which begins with an initial health concern. We follow the journey to when they follow up with a doctor for their chronic medical conditions.
The US healthcare system is a disease-based model. The clinicians – whether PAs, NPs, MDs, or DOs earn more if they do more.
Understanding the US healthcare system isn’t easy. I know. I hope that this course helps you better understand your patient journey.
There are few services or products for which you don’t pay directly. Gmail is one example, and we have seen the data privacy fallout.
For example, when you go to the grocery store, you pay for the apple presented before you with your own money. The store clerk and the orchard are directly responsible for what they sell you.
In healthcare, we use health insurance. This creates a lack of transparency and a middleman in the patient-doctor relationship.
Paying for Healthcare
Speaking of lack of transparency, the patients don’t pay the doctor directly, leading to cost secrecy. The health insurance company settles the bill with the billing department for the physician.
That’s why you can get a spine MRI for $500 cash if you claim you don’t have insurance and walk into an imaging center yourself.
However, using your health insurance card for the same MRI would be more expensive. The hospital bills the insurance $3,000, half of which is paid out.
The insurance company accepts this spread because they also deny claims, and of course, it allows for an ongoing lack of price transparency. Which we go into in the course as well.
For now, understanding the basics of the US healthcare requires following the train of money.
As a physician, I often refer to UpToDate to look up the latest treatment and management recommendations. This is good and bad, as discussed in the course.
I will often reference the IDSA, where ID experts will opine on a particular condition for infectious diseases. They dictate the appropriate treatments.
We follow many other professional society guidelines in western medicine as listed below.
Rheumatology has the ACR.
ACOG creates the obstetrics and gynecology guidelines.
The AAP represents pediatrics. Note that I didn’t say they represent pediatricians.
AAFP for family medicine.
Internal medicine has several such groups. One of them is SGIM.
Since western medicine is a highly regulated profession, I can’t just develop my algorithms and protocols to treat patients. We discuss this issue in more detail in this online course.
I might believe that the patient needs a particular lifestyle intervention or holistic approach. Still, if that’s not supported by western medicine – if it’s not evidence-based – I can’t recommend it.
In the course, we dive into how “evidence” is established in medicine and why it can create conflicts of interest.
Conflicts of Interest
Each state adopts the Medical Practice Act, which governs the practice of western medicine in that state. It’s up to the regulators (state medical boards) to determine if I’ve been compliant with the profession’s standards.
This heavy regulation burden leaves many clinicians feeling paranoid and leads to the practice of defensive medicine.