tag:blogger.com,1999:blog-32053362.post2147426943640819078..comments2024-03-29T05:39:11.334-04:00Comments on Not Running a Hospital: Minor deities?Paul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-32053362.post-7524296808451227742008-09-26T04:27:00.000-04:002008-09-26T04:27:00.000-04:00The very best doctors are clear thinkers who emplo...The very best doctors are clear thinkers who employ the basic tenets of science -- and recognize patients as experts on the symptoms they present. The worst are among those who rely on trends for diagnosis and -- because they are expected to be all-knowing (everyone's fault) are afraid to say "I don't know" when appropriate -- or, similarly, suggest "this doesn't exist" when unable to provide an answer. <BR/><BR/>Doctors and patients -- who must also be held to standards of reasonability and disciplined self-help -- need to form equal partnerships in the process of factual discovery leading to optimal medical results. <BR/><BR/>Likewise, while everyone must understand the limitations of treatment, all parties in this alliance have to be politically aggressive in insuring that research dollars flow toward dead-end diagnoses: "nothing else we can do" is oftentimes the result of unimaginative, insurance-driven or even lazy approaches to disease. Doctors and patients need to bring energy to the plate, "apportion their beliefs to the evidence," and cooperate in maximizing health.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-37636973142024076502007-07-07T22:49:00.000-04:002007-07-07T22:49:00.000-04:00Here is an interesting link that explains better t...Here is an interesting link that explains better than I ever could why both patients and doctors are unhappy:<BR/>http://homepage.mac.com/dtoub/blog/C1162157567/E20070707004823/index.htmlAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-18815957653780332212007-07-05T20:29:00.000-04:002007-07-05T20:29:00.000-04:00This topic of doctor as terrorist has received som...This topic of doctor as terrorist has received some attention on other medically related blogs as well - see Kevin M.D. and Respectful Insolence, especially the latter. They raise some issues that may make Paul's title of "minor deities" seem ironic and scary.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-18465683010293154462007-07-02T20:02:00.000-04:002007-07-02T20:02:00.000-04:00I'm shocked by the news that the British have arre...I'm shocked by the news that the British have arrested at least three doctors in the attempted terrorist acts. I hope this will not create a backlash against foreign doctors here. We don't expect doctors to hurt people so it is especially shocking when they do.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-24896089962304974222007-07-01T16:45:00.000-04:002007-07-01T16:45:00.000-04:00Barry gets a home run gold star from me.The extrao...Barry gets a home run gold star from me.<BR/><BR/>The extraordinary wonderful doctors who've worked on me this year, and the other caregivers who are at the top of their craft, are absolutely great.<BR/><BR/>I encourage all those docs to tell the AMA to shut its fat mouth about political positions that hurt the profession's reputation. The AMA's <I>real</I> goal ought to be improving care as WE experience it - and if the AMA thinks we're not qualified to judge, then that kinda bolsters the Minor Deity perception, doesn't it?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-45571562881060082822007-07-01T12:12:00.000-04:002007-07-01T12:12:00.000-04:00Bravo! Very thoughtful. This is a rapidly evolving...Bravo! Very thoughtful. <BR/><BR/>This is a rapidly evolving world. Therefore, the profession must change to continue being the same. If we fail to do so by ourselves, we will be forced to.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-22939883780610211492007-06-29T15:52:00.000-04:002007-06-29T15:52:00.000-04:00As an IT guy, I have an immense respect for doctor...As an IT guy, I have an immense respect for doctors as walking information systems. The amount of data they handle in an hour is astonishing. The ability to form quick diagnoses based on past experience, yet keep an open mind is a delicate balance act, requiring constant adjustment.<BR/><BR/>In short, they amaze me. I do respect the craft. As a diagnostician myself, I am suitably impressed. <BR/><BR/>I do not respect how health has become a big, market and advertising driven business, and I have to say that a class of doctor helped start that trend well before it leaked into the insurance biz. <BR/><BR/>I expect doctors to be very well compensated. I don't expect my body to be a product, or a consumer of services. That kind of thinking is trading in life and death, with market forces taking the place of a solemn oath as one of the few professions that pledges to help people, no matter what. <BR/><BR/>Doctors have to take some of the blame for that as much as big business. Just as I have to take the blame for my health problems as much as our society's placing a premium price on healthy, fresh food. <BR/><BR/>I understand the frustration, but they have the power. I don't. I'm just a lousy consumer, whose choice is "accept what we give you, or drop dead." I can't boycott critical care. <BR/><BR/>Physicians, heal thine own craft. I'll be happy to help, what with my computers and people skills, but it's up to you guys to save us from the idea that we shouldn't expect help unless we're economically worthy.Robhttps://www.blogger.com/profile/14085759273215853991noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-15652326840359685322007-06-28T23:49:00.000-04:002007-06-28T23:49:00.000-04:00I like what Barry has to say... very wise. I also...I like what Barry has to say... very wise. I also couldn't agree more with Paul's assessment of physician sentiment: "doctors feel that their professional judgments are overridden by faceless bureaucrats in insurance companies and at Medicare..." That is so true. Nothing gets us angrier than having critical services denied to a patient in need by some gum- chewing third party via telephone -- who knows nothing of medicine, the details of the patient's case, or the critical importance of the test or service. If health plans and Medicare are going to play doctor, then why do we go to medical school?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-10289072220620221402007-06-28T16:33:00.000-04:002007-06-28T16:33:00.000-04:00I've had considerable experience as a patient over...I've had considerable experience as a patient over the last 10 years or so (CABG, DES, TURP and several other procedures). The doctors I've encountered were excellent, and I admire their skill and dedication. I'm alive today because of that skill and the wonders of modern medicine, including prescription drugs.<BR/><BR/>That all said, here is my wish list for both individual doctors and the profession generally:<BR/><BR/>1. Treat me as though I am a member of your own family (provide professional, competent and compassionate care) and as though you were paying the bill out of your own pocket (no unnecessary tests that are driven mainly by defensive medicine).<BR/><BR/>2. Embrace price and quality transparency so both you and I can more easily identify the most cost-effective specialists, hospitals, labs, imaging centers and drugs.<BR/><BR/>3. Accept competition when appropriate. The recent rhetoric from the AMA against retail clinics staffed by NP's or PA's, for example, is not helpful.<BR/><BR/>4. Admit mistakes and do a better job of weeding the comparatively few less skillful doctors, who account for a disproportionate share of malpractice, out of medicine.<BR/><BR/>I think the profession's historical resistance to #2, 3, and 4 may, at least in part, account for its arrogant image among much of the public.Anonymousnoreply@blogger.com