Is sick care capitalism a problem or solution?

During a recent talk I gave to 1st year medical students about sick care innovation and entrepreneurship, one of the faculty hosting the session expressed concern about too much emphasis on entrepreneurship, money, and profits over other patient care concerns. Has profit overtaken patient care as the primary driver and was it sending the wrong message to impressionable medical students starting their careers? Has the 1980's "greed is good" ethos returned?

When I asked the students to respond, some said it was important for them to understand the business of medicine, most were silent, but one gave a full-throated defense of capitalism, the profit motive and how it drives the American economy, include the sick, sick care system of systems.

A recent opinion article would agree , noting that:

• In 1990, American income per person was 24 percent higher than the income per person in Western Europe. Today, it is about 30 percent higher.
• By 2019 households headed by millennials were making considerably more money than those headed by the Silent Generation, baby boomers and Generation X at the same age, after adjusting for inflation.
• In 2013, Thomas Piketty published a much discussed book called “Capital in the Twenty-First Century” arguing that widening inequality is an inherent feature of modern capitalism. The problem is that right around the publication of his book, inequality stopped widening,?the economist Noah Smith notes , and?it now appears to be slightly decreasing.
• The American model of capitalism is under assault. But it has proved superior to all real-world alternatives.

But not everyone in US society benefits the same.

The reality is that 1) the US sick care system of systems is a $4.3T business representing 18.3% of US GDP and is forecasted to grow to 6T in the next several years, and 2) the challenge for stakeholders, including the growing numbers of sick care entrepreneurs is to reconcile the culture and ethics of medical care with that of business and American capitalism.

Doctors are the solution, not the problem. We need to teach the business of medicine in medical schools to arm graduates with the knowledge, skills, abilities, and competencies to be successful, regardless of their eventual career path. In many instances, like it or not, for investors and leaderpreneurs, there is a sextuple aim-creating shareholder value.

Your opinion may depend on whether you practice blue medicine or red medicine.

Understanding the system is critical to fixing it. Diagnose first, treat later. Of all people, Michael Douglas understands the value of how capitalism drives innovation. This actor and producer was diagnosed with stage IV oral cancer in 2010. He first said the cancer was in his throat. He actually had tongue cancer, which can require disfiguring surgery. Douglas said the cause was human papillomavirus?(HPV) he caught from giving oral sex. HPV, a very common sexually transmitted virus, is the No. 1 cause of throat cancers and can lead to tongue cancers. After radiation and chemotherapy, Douglas is now healthy. Now there is a vaccine to prevent it in men and to prevent cervical cancer in women.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs