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Saturday, June 12, 2010

Compromises Made in Medicine

Inspiration from the Campo dei Feuri in Roma, Italy

Campo dei Fueri is a great people-watching square. When my wife and I arrived on a sunny, hot Italian Sunday, a flood of people in Italy passed us by. Sipping our drinks (see photo of my wife Patty in the middle in blue) thousands passed the tiny outdoors cafĂ©. Their individual stories would have been so fun to hear. The square has many historical points, but the large central statue of Giardano Bruno (see photo), burned at the stake for his beliefs in 1600, dominated the scene. What got him into trouble you may ask? Bruno believed the world was round. He felt strongly enough that he could not keep it secret. He died for what he believed in!!

This would never happen in medicine in the 21st Century. But, you do see a subtle selling out by medicine to the dictates of insurance companies. It is usually a subtle undertone in the treatment plan when the healthcare providers chose for their patients only tests, products, etc. that are covered by the insurance. The patients are getting sometimes a small view of all their treatment options.Providers must sit back and look at their practice. Are they compromising too much?? With all of the changes in health care technologies, and the added experience of those practicing medicine, every clinician should be practicing at a higher level with better outcomes than 5 to 10 years ago. Is this so? If not, what can be done to change things about the practice? Is too little time being spent with patients?  Are all the treatment options been carefully explained to the patient, especially when there are many choices?

And what about the patient’s role? Patients are getting more and more squeezed with higher premiums. If they can choose between two treatment plans, one cheaper than the other, cheaper sounds gooood! But is it appropriate to help?

As I mentioned in my post on the K.I.S.S. principle, keeping things simple is normally a great starting point. Simple is normally less expensive since it is more patient-time involved, and less doctor/therapist-time involved. However, with office visits getting shorter, patients may not be getting a good picture of their choices. Only one treatment plan may be presented. In my business, treatment plans can often be numerous, based on many factors. Patients must speak up and ask for their options. Be more vocal. Express when money is of great, or of no concern (usually when the initial treatments are not effective, and the patient begins to feel very vulnerable). Definitely, the way medical reimbursement is going, all patients will be asked to pay for more. Doctors and patients must become well versed in the K.I.S.S principle with cost-effective treatments that have good positive outcomes. We are a wee-bit overly tech happy, which definitely costs more.

So what have I learned from Bruno. He gave me more resolve to not sacrifice any treatment for any reason. He reminded me to fight for my patients by standing up for what I believe. I won’t be burned at the stake, but I must daily feel joy in my ability to help patients the best I can. This way I will enjoy practicing medicine, and all its sacredness.

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