Frank's Musings

The Republican Party that has survived the winnowing it suffered under the Trump Presidency Is resultantly dominated by politicians who have abandoned any policy objective but the furtherance of their own careers. Success in winning voter support was gained in 2016 by satisfying the frustration of a near majority of citizens with their perceived loss of control over their financial and civic affairs to wealthier and better educated “elites.” If more broad minded voters are careless of the need to act vigilantly during another presidential election, they will abdicate again their influence over federal government policy.

The healthcare providers of Johns Hopkins Medicine (and eventually, for sure, the rest of medical practitioners everywhere) have decided that the convenience that modern communications technology has granted their patients deprives their professional expertise and reputation for customer service of adequate compensation.  They have decided to charge fees for many of these remote electronic consultations.

Some of the aging and, therefore, more medically challenged yet technologically sophisticated people that health care practitioners serve have apparently abused MyChart by using its up-to-now free messaging feature to avoid having to visit their doctor’s office when they have a health problem that used to require a billable examination and/or personal treatment.  Naturally, the rest of patients have been tempted to consult with their physicians by MyChart or email instead of by placing a telephone call and hoping for an answer despite the tight schedules most doctors are forced to maintain owing to the parsimonious administrators of health insurance plans.

Of course, most healthcare patients like to use remote consultation with their physicians whenever they believe they can--laymen often overestimate their understanding of their medical conditions.  In the case of clarification of therapeutic instructions or other follow-up questions, Johns Hopkins has indicated that no charges are contemplated.  And, of course, physicians can always answer such questions by demanding an office visit; but it seems that the advance of communications technology has outpaced the standard clinical practice business model.

GPT Artificial Intelligence also threatens the basis of that business model.   AI potentially commodifies medical expertise, fooling patients into believing that they can master the intricacies of medical diagnosis and treatment through intelligent use of the Internet.

In any case, medical insurance plans must also cover the fees that healthcare practitioners can justifiably charge for advising their patients electronically. This addition to the availability of their services is as much a convenience for medical practitioners as for their patients.  Moreover, effective use of virtual office-visit services gives a competitive edge to those healthcare providers who offer them.  On the other hand, commercialization of MyChart threatens to advance the transactional nature of doctor-patient relationships when many other aspects of human life are already losing much of their communitarian intimacy.

The Preamble of the U.S. Constitution states, "We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”  It guarantees that whatever appears later in that document will help ensure what has been defined to mean a more perfect union and the general welfare in the over 200 years since the Founding by public discourse and preceding decisions of the Supreme Court itself.