America’s Health Care Delivery System is Dysfunctional

Here Is Why

Author’s Image from Fixing The Primary Care Crisis

This is the 1st article in a series on America’s dysfunctional healthcare delivery system.

I wrote an article recently on cardiovascular syndromes after mild Covid-19; one more aspect of Long Covid or Long Haulers. I began with a story of a friend who had been mis or undiagnosed and probably initially disbelieved. Did the physicians, including her primary care physician, spend enough time to truly understand her symptoms? Did they make the connection between a recent episode of mild Covid-19 and the ensuing syndrome? Where they aware of the Long Covid syndromes? Did they take the time to do some research to better understand?

In a comment related to the patient’s story, it was suggested that the American medical delivery system is truly dysfunctional. I agree. This has prompted me to write this series of articles to define, address and offer opportunities for improvement — improvements that will make medical care better, will reduce patient frustration and anxiety, and greatly improve physician well-being, the latter now being at rock bottom.

To begin, consider this true story. The patient’s name and some characteristics have been altered to protect anonymity. It is adapted from my book Fixing The Primary Care Crisis which was a sequel to The Future of Healthcare Delivery.

Susan is 56, married, insured, a successful professional and is in generally good health. She began to have a strange sensation in her right chest, which she described as a shooting sensation almost electrical or vibrational in nature which stretches from high up in her right chest down as a narrow line over her rib cage and onto her abdomen. It seems to be immediately under the skin, starts intermittently and ends at no set time. She visited her primary care physician (PCP) and gave this description, adding that she was concerned that it might be her heart. The doctor asked additional questions and did an exam and electrocardiogram. All were normal except for the description of the sensation Susan was feeling.

Her PCP was now running out of time for this fifteen-minute visit. Here was a fork in the road with two paths. One path was to say that it was a real sensation but nevertheless he could reassure her that there was no…