25 May 2012

Restoring the sanctity of the patient-physician relationship. Part 1

Posted by Jody under: Wellness .

Restoring the sanctity of the patient-physician relationship

There was a time in this country when patients trusted their doctors completely…trusted them with their lives…and listened to them and heeded their advice and friendly consultation. You could talk to your doctor in privacy behind closed doors and you felt entirely confident that what he or she recommended was 100% in your best interest.

There was also a time when doctors thought of little else but treating and caring for their patients, and doing everything in their power to offer their patients the best medical care known to science. They trained long and hard in medical school and took an oath to provide the best care possible to their patients, regardless of cost, and make their own selfish interests secondary to their chosen vocation of healing and doctoring.

But something happened in the United States of America. A wedge was driven between patient and doctor. For one thing, our society became increasingly litigious. Doctors, fearing lawsuits, frivolous or otherwise, began practicing defensive medicine — they became a little more detached and self-protective. And patients, having once perceived their doctors as friends, advocates, and teachers, began seeing dollar signs and spiraling healthcare costs. Were doctors practicing medicine to line their pockets? Were they in it for their patients or for those fancy European sports cars, exclusive country club memberships, and frequent vacations to various tropical paradises? Could anyone really tell?

Did “fee-for-service” medicine create a perverse or corrupting set of financial incentives for doctors? Why in heaven’s name were they ordering so many diagnostic tests? Why were they using so much high tech equipment? And why were there so many coronary bypass operations, hysterectomies, and cesarean sections in this country, anyway? Had good, old-fashioned vaginal birth gone out of style?

To make a long story short, people started keeping close tabs on healthcare expenses. It was determined that spending close to a trillion dollars a year on healthcare was too much…that it was bankrupting the country, and that even with such immense expenditures, many Americans still weren’t receiving the medical care they needed. (For example, infant mortality is higher in the U.S. than in other industrialized nations). People were falling through the cracks in the system, even with Medicare and Medicaid. The U.S. healthcare system was said to be broken and in dire need of repair. Enter the politicians. Healthcare became a political issue. Strike that. Political hot potato is more like it.

The Clinton Administration banked on comprehensive healthcare reform. But the issue was more complex and controversial than anyone expected. Americans, it turned out, had pervasive fears of big (and inefficient) government involvement in their healthcare, and throngs of well- heeled lobbyists roundly and soundly defeated healthcare reform in Washington, D.C. The hot potato was subsequently tossed back to the individual states. The health insurance companies, threatened with their own possible extinction under nationalized healthcare delivery and a government- run single- payor system, breathed a deep sigh of relief.

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