Physicians consumer demand

Consumer demands for greater access to medications has prompted the development of a fourth tier. This differs in that it introduces the concept of coinsurance, or percentage copay to consumers. Medications in this tier would be covered as a percentage of total medication cost as opposed to a set copay amount. For example, fertility medications might be covered at 50% of their total cost. The patient would pay 50% and the pharmacy benefit would pay 50%. Thus providing the consumer and the physician with an incentive to discuss considerations of cost. 

The Industrial Revolution created an enormously increased industrial and middle-class consumer demand for commodities that entailed lead in some form. These demands in turn produced a greatly expanded population of lead workers who were clearly lead poisoned at the workplace, given the relatively primitive working conditions. The nature and extent of the occupational lead problem was documented in the classical 1839 work of the French physician Tanquerel des Planches. As noted in the 1848 English translation from the French of this opus, all classes of occupational uses of lead were accompanied by recorded lead poisoning hazards. 

At the consumer s end, the situation is even more confused. Drugs are taken by the patient, prescribed by the physician and paid for (to a varying extent in different countries) by the state or by insurance companies. Thns, the usual market constraints are lacking. On the other hand, the state, insurance companies and hospitals sometimes have much of the power of monopoly pnrchasers -so-called monopsonists. hi many conntries, the state licenses individual pharmaceuticals and sets their prices. In the negotiations with drug companies, the nsnal price determinants of snpply and demand are replaced by political considerations. 

The extraordinary advances in digital, medical, and scientific technology over the past decade have had a tremendous impact on the way in which we live and work today. Nowhere is this more evident than in the high tech realm of pharmaceutical research. The completion of the Human Genome Project, the increased speed and power of computers, and the invention of sophisticated laboratory equipment and techniques have opened up new avenues of discovery that are rapidly paving the way toward tomorrow s blockbuster drugs. Outside the labs, both the Internet and the media have provided consumers and physicians alike with instant access to unprecedented amounts of medical news and information. This not only fuels the demand for better, faster treatments but it also redefines the arena in which companies vie for sales and market share. 

An integral part of a physician s practice is addressing the occupational healthcare needs of the patients. This responsibility includes identification of occupational and environmental health risks, treatment of disease and injury, and patient counseling concerning preventive behavior. This task by itself is time-consuming and presents demands that, in part, can be performed by the occupational health... 

Traditionally, the focus of healthcare providers has been the diagnosis and treatment of the sick. This is a puU (reactive) system that attempts to satisfy the consumer only when he/she falls Ul. While a reactive response to a consumer product can lead to efficient resource utilization, it may result in high costs in healthcare. An extreme example of a pull system is the emergency room (ER) -patients delay seeing a physician for various reasons and, when it becomes a life threatening case, they are rushed to ER. Demand at an ER can be uneven and the treatment very expensive. 

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