A new survey in the journal Health Affairs journal synthesizes nearly everything I believe is wrong with the US healthcare system. The survey found that patients believe that more care is better, that the latest and most expensive treatments are the best, that none of their doctors provide substandard care, and that evidence-based guidelines are a pretext for denying them the care they need and deserve.
Until we can retrain consumers (that would be all of us) to understand that in medicine more is NOT better, that evidence-based guidelines may translate in some instances into less but better care, that doctors are falliable and should be questioned, and that the cost of a treatment has nothing to do with the quality, we will never get out of the healthcare quagmire in which we find ourselves.
2 Responses to “When Is Enough Enough?”
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It is so interesting to me that the same doctors who believe their patients won't change their beliefs and behaviors don't make the time and exert themselves to change their own. OF COURSE, the clinician has to lead the way, and OF COURSE the patients have to be empowered as partners in their own care. And OF COURSE, it's not easy to stand firm against the power of the “easy fix” that is so pervasive in society. But I know many physicians (from a variety of disciplines) who do just that. They see fewer patients, take more time with the ones they see, offer both education and alternatives, and constantly educate themselves and their patients about non-drug options. They do not expect patients to come in already educated and empowered — they understand that healing happens in relationship and they take their role in the doctor-patient relationship very seriously. I wish there were more like them, but I certainly know this approach is both possible and effective.