December 29th, 2010 by eDocAmerica in Better Health Network, Opinion
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Recently, I was involved in a discussion on an email list serve and decided to takes some of my comments on patient autonomy and blog about them. This arose following a debate about whether the term “patient” engendered a sense of passivity and, therefore, whether the term should be dropped in favor of something else, like “client” or something similar.
Having participated in the preparation and dissemination of the white paper on e-patients, I don’t see the need for “factions” or disagreements in the service of advancing Participatory Medicine. As Alan Greene aptly stated: “This is a big tent, with room for all.”
I want all of my patients to be as autonomous as possible. In my view, their autonomy is independent of the doctor-patient relationship that I have with them. They make the choice to enter into, or to activate or deactivate, the relationship with me. They may ignore my input, seek a second opinion, or fire me and seek the care of another physician at any time. They truly are in control in that sense. The only thing I have control over and am responsible for is trying to provide the best advice or consultation I can. Read more »
*This blog post was originally published at eDocAmerica*
December 29th, 2010 by GarySchwitzer in Better Health Network, Health Tips, News, Opinion, Research
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Dr. Kent Bottles is in the midst of a very thoughtful multi-part blog post under the heading, “The Difficult Science Behind Becoming a Savvy Healthcare Consumer.”
Part I examined “the limitations of science in helping us make wise choices and decisions about our health.”
Part II explores “how we all have to change if we are to live wisely in a time of rapid transformation of the American healthcare system that everyone agrees needs to decrease per-capita cost and increase quality.”
Both parts so far have addressed important issues about news media coverage of healthcare. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
December 21st, 2010 by Michael Sevilla, M.D. in News, Opinion
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Every once I awhile a story catches my eye as I scan the news websites. There was one this morning on CNN with this catchy title: “Mom Defies Doctor, Has Baby Her Way.” The article describes a story where a mother was going to have her fourth baby. Her previous three were born via C-section. Mom did not want another C-section done, and “defied” her doctor’s order for the procedure. “You’re being irresponsible,” the patient was told.
The middle of the article talks about the current thinking and statement of the American College of Obstetrics and Gynecology saying that “it’s reasonable to consider allowing women who’ve had two C-sections to try to have a vaginal delivery.” Of course, there’s risks with proceeding with a vaginal delivery and risks of another C-section.
What’s always interesting to me are the comments following the article. I applaud the physicians who are fighting back the anti-physician sentiment and those who are pushing (no pun intended) the only home birth agenda.
In the article, this person is being held up as a hero — as someone who defied the paternalistic medical establishment and did it her way. Good for her — or is it? What if that 0.4-0.9 percent possibility of severe complication occurred and there was a problem with mom and/or the baby? What would happen then? Read more »
*This blog post was originally published at Doctor Anonymous*
December 20th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Opinion
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The Internet has threatened journalism. Clay Shirky has said that everyone is a media outlet. An Internet connection and blogging platform makes everyone a publisher. Can the mass professionalization of journalism be applied to medicine or health? Can access to a broadband connection outfit a citizen to think and act like a physician?
There are pieces of what physicians do that can be replicated, and other pieces that can’t. The technical things that doctors do can’t be replaced. Removing an appendix or replacing a heart valve, for example. Tough to pull off on CureTogether.
But what about the thinking? After all, patients have access to the same information, references, and literature as physicians. Unfettered access to information can create an illusion. It can give us a false sense of control. Read more »
*This blog post was originally published at 33 Charts*
December 15th, 2010 by Michael Sevilla, M.D. in Better Health Network, News, Opinion, True Stories
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My professional organization recently asked me to participate in an interesting meeting at the state capitol talking about healthcare payment reform and how to improve the healthcare delivery system. This was sponsored by the state of Ohio and their Health Care Coverage and Quality Council.
It was the first meeting that I’ve been to where there were physicians, hospitals, insurance companies, and patients — all trying to put our heads together — present our points of view and try to come to consensus. Did we come to consensus on solutions? Not really, only that we will continue the conversation. There is no perfect solution that will make everyone happy, but we will strive to try to get to that best imperfect solution.
When is comes to healthcare delivery and healthcare payment, there was a lot of discussion on physicians and hospitals — meaning healthcare providers. The motivating factor in these cases uses terms like payment, lack of payment, incentives, bonuses, and penalties. Read more »
*This blog post was originally published at Doctor Anonymous*
