Competition key in drug pricing, and let's not forget value, and other letters

Regarding the Aug. 29 editorial “The unaffordable cost of M&A-driven drug prices," goods and services in a free market are nearly always priced based on market forces—most notably a combination of value perceived and competition—not the cost of production. Gold and diamonds are found lying in the ground, as is oil. The solution to high prices is more competition, not more regulation.

Missing also from the discussion is the value delivered by drugs, which is hard to gauge and highly dependent upon whether you are receiving care or paying the bill—often different in our third-party payment system. When I was in medical school, a heart attack was treated with oxygen and morphine, both pretty cheap. Hodgkin's lymphoma was effectively a death sentence. Things sure have changed. What's that worth?

Dr. Edward Fotsch

Regarding the article “Influential healthcare leaders set principles for patient-centered care," most physicians today will tell you that medical school taught them how to diagnose and treat the disease present by “the body in the bed” (a disease-focused approach to care delivery). If asked, they will tell you that they weren't well trained to talk to or get to know “the patient in the bed” (a patient-centered approach to care delivery).

I estimate that up to 70% of practicing physicians still employ the same disease-focused approach they were taught in medical school years ago. This estimate is based on an evaluation of 500-plus physician-patient visits that considered the communication style and skills routinely employed by physicians in patient exam room visits; and the number of unsuccessful patient attempts to initiate conversations with physicians during exam room visits about a health concern, request or need.

Absent a concentrated focus on helping physicians become more patient-centered, all the transformation efforts being exerted by hospitals and other provider organizations will be undermined by what happens every day in their physicians' offices and hospital rooms.

Principal

Mind the Gap Academy

San Jose, Calif.