25 May 2012

Restoring the sanctity of the patient-physician relationship. Part 3

Posted by Jody under: Wellness .

One big problem is that, despite a veritable cornucopia of clinical guidelines available to practically every doctor, nurse, physician assistant and other physician “extenders” in the system today, no one really knows at this stage in the game what constitutes under-utilization or over-utilization. That missing bit of information is being worked out by hundreds, perhaps thousands of experts in a burgeoning industry called “outcomes research.”

Researchers hope to amass data on what procedures or treatments really improve the lives of patients…by helping them to live longer, live more comfortably, or be happier or more content with the quality of the medical care they received. “Medical quality” is another one of those vague and fuzzy terms that the experts have yet to define satisfactorily. For in 1995, when we can track the cost of healthcare down to the fraction of each penny spent, we don’t know what medical quality really means. In broad terms, it probably has something to do with whether you get better or not — with whether you live or die. But many doctors are losing the ability to make that judgment call. What care is “appropriate” and covered, and what is not, is often defined in a seemingly arbitrary manner by managed care corporations and fashioned into hard-and-fast health insurance policy — which is the insurance industry’s equivalent of legal gobbledegook. Have you ever been able to read an explanation of covered benefits booklet given to you by a health insurance companies and really understand it? Didn’t think so. And guess what? There’s probably a reason for that which works to the benefit of insurance companies — not healthcare consumers.

By now, you’ve probably heard the terms “corporatization” of medicine or “market-driven” medicine. What this means is that healthcare, and the delivery thereof, becomes a commodity subject to the same laws of the marketplace as soda pop, breakfast cereal, used cars, toaster ovens, and personal computers, for that matter. Is cheaper always better? Are there principles nearer and dearer to us than just saving a buck? Has our emphasis on cutting costs resulted in cutting some very important corners?

“Health care is not toilet paper,” said Barbara R. Reed, M.D., President of the Denver Medical Society, in an editorial published in the Denver Post. “As physicians we know that all too well, but we had better spark that realization in others.”

She’s right, of course. You can easily replace one roll or ten thousand rolls of toilet paper. But when you lose that special, trusting relationship between patient and physician, you’ve lost something truly irreplaceable, unique, and desirable — yes, desirable.

The relationship between you and your family doctor, for example, is the cornerstone of your healthcare. Your family doctor knows you, knows your medical history, knows your lifestyle preferences, and knows and understands the context of your familial and other social relationships. There’s value in that. Not just medical value, but something that transcends the measurable clinical benefit. “Continuity of Care” is the term used to describe an ongoing relationship with your doctor. It can be one of the single most valuable tools you have in the preservation and maintenance of your health. It’s something you should insist on. And be willing to fight for.

When you have severe disease so need to take several rx medications, the costs can become a difficult problem. Internet pharmacy will provide you an effortless method to buy prescriptions drugs online at a more affordable cost.

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