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The 3rd Paradigm Shift In Medicine

By Robert Keller MD

We are in the 3rd paradigm shift in medicine.

The first evolution occurred during the American Civil War when medicine developed standards for surgical procedures. The second shift occured during the early 1900 with the introduction of pharmaceauticals and the start of internal medicine. Both of these practices were reactive based medicine; in other words, after the fact medicine. The United States became the center of reactive medicine by developing empirically based evidence to support the treatments. Still, the model was reactive. Thus, we became adroit at treating disease after it had declared itself with symptomatology. The twenty First century now enters the 3 medical revolution: proactive medicine. We now have the ability to develop protocols that predict disease very early in the disase state or more excitingly before the disease expresses itself. Treatments such as stem cells, DNA and protienomonics, advanced labs such as telomer testing, virtual angiograghy are just a few of the prospective ways to prevent disease.

Yet, a challenge remains. How do we as physicians shift to the proactive revolution when the third party carriers reimburse for reactive treatments? Therein lies the rub. It is my contention that a cash based model for paying physicians for proactive services will evolve until the insurance data tables reflex proactive medicine is less expensive that reactive treatments. As we all know, this will take years. So, my advice: begin to incorporate a cash based element into your daily practice. It's good "insurance".

About: Robert Keller, MD is a world renown physician who specializes in cash based proactive medicine.

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Reader Comments (1)

In total agreement, yet many physicians opt to add cash-based services that make little sense for their markets or they invest in service lines that may take years to achieve positive ROI. If anyone is interested in a complimentary consult and introductions to great turn-key zero or low-cost ancillaries, contact me via or at 800-975-3290.

Nina Grant
VP, Agency Managing Director, Practice Builders
Managing Partner, Ancillary Practice

Mar 5 | Registered CommenterNina Grant

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