Viewpoint: Perception of scarcity is one of healthcare's greatest ills

A perspective published in The Lancet based on the views of medical sociologist Arthur Frank, MD, PhD, makes the case that the myth of "scarcity" encourages unnecessary healthcare consumption. 

The viewpoint is based on the concept of the "scarcity loop," which Dr. Frank is quoted in The Lancet as describing as, "the endemic contradiction in healthcare between the hopes, desires and expectations that capitalist techno-science thrives on generating, and the realities of what can be delivered and who can afford what."

Under the assumption that healthcare resources, like funding and physician time, are scarce, patient care suffers and the system is no better for it, according to authors Rupal Shah, MD, and Dr. John Launer. 

"The implication of this model is that perfect health might be achieved if there were available an endless resource that allowed unlimited investigations, medications, surgery, and other interventions. Hence, we are constantly pursuing that unattainable end, without realising it," they wrote.

They challenge physicians and other healthcare administrators to question the scarcity loop and work against it. This is a tall order, as it is baked into our concepts of economics and capitalism, they note. But they believe reimagining this "governing myth" into one that uses kindness and patient connection as currency can ultimately transform patient care.    

"By moving from hasty appointments to calmer ones, from transactional to relational encounters, and from transient patterns of medical work (like locum contracts) to longitudinal commitments, we might actually save everyone time — for example, by not ordering unnecessary and sometimes harmful investigations and treatment with consequent medicalisation and repeat attendances," they wrote.

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