Relational Dynamics and Health Economics: Resurrecting Healing

Primary care physicians' and allied healing professionals are overwhelmed with greater demands to provide complex care within business structures that either mandate high volume or exorbitant fees for service in order to support healthcare needs or sustain their livelihood. Statistics within the USA note that 40 to 50 percent of primary care physicians practice consists of complicated care. There are continued decreases within the USA of medical doctors who enter general practice and most choose to enter specialties where they are able to dictate their hours of availability and are reimbursed at a higher rate for services. The exception lies in psychiatry and pediatrics, where there is a shortage of providers and low fees for service. Models that have been proposed to alleviate issues related to these shortages include models of integrated health care, where physicians provide holistic care or partner seamlessly with others to provide total care at a single location. Physician extenders have been developed as an alternative where Master's Level Nurses and Physician Assistants are allowed to practice in the same setting and under the supervision of the licensed physician to deliver care. The intent of the physician extender is to allow the physician to spend greater time with more complicated cases and for the assistants to provide routine care. The issue becomes differentiating when a patient presents with a routine issue but actually requires complex interventions. When traditional physical medicine is combined with a need for psychological counseling the needs are complex, and medical doctors or physician extenders are provided with only a three month rotation in psychological diagnosis and interventions. Both socialized non-socialized medicine do not have a practice model in which they provide adequate care and holistic healing. This paper proposes a new model of providing holistic healthcare based upon relational dynamics in an economically sound manner.