Next week, the National Press Foundation offers an “all-expenses-paid, educational program on cancer issues” for journalists, with all expenses paid by Pfizer. I’ve written several times about my criticism of this approach.
I’m unable to attend either event because of prior commitments, but suggested to NPF that they ask Merrill Goozner to speak instead. He’s right in Washington, has written and lectured about conflicts of interest in healthcare, and was available. Goozner told me he has not been contacted. So, since I can’t attend and since critical voices probably won’t be represented at the first workshop, I have posted some video clips of what others might have said if given the opportunity. Read more »
This video was [recently] shown at the 2010 American Academy of Family Physicians annual meeting in Denver. The theme is simple: “We are here. We are listening. We are healing. We are family physicians.”
People ask me all the time “what do you do?” There’s no easy way to explain all the things that I do as a family physician. In addition, each family doc in each community is unique. That’s kind of part of the difficulty of answering the question. But I believe this video does a good job of trying to encapsulate who we are as family physicians:
No matter where one stands on appropriateness and advantages of each patient being involved in self-diagnosis and treatment of their own medical problems there are two inevitable conclusions:
• First of all, self diagnosis and treatment are as natural as breathing and as impossible to extinguish as thought itself.
• Secondly, given today’s healthcare system, there always will exist a dynamic tension between self-determination of the individual patient and the powerful healthcare system which often insists on patients falling back in line and complying with orders.
Few would argue against the need for a powerful alliance that embraces the benefits brought to the table by both the practitioner and the patient. Simplistically, the physician would carry the role of healthcare consultant and guidance while the patient ultimately becomes responsible for the choices. Read more »
The famous late 19th and early 20th century physician, Sir William Osler, said that “a physician who treats himself has a fool for a patient.” How would he have felt about patients diagnosing and treating themselves? Would he have written in support of the Journal of Participatory Medicine or against it? I also wonder how he would have practiced medicine in the “information age” when many of our patients present with a diagnosis already made, right or wrong.
I recognize that bringing Dr. Osler into a discussion set in the information age is, perhaps, anachronistic. Yet I believe he still has something to teach the 21st century on the topic of patient participation. When he advised that “the first duty of the physician is to educate the masses not to take medicine,” he offered one of the earliest lessons on a physician’s role as educator.
He also said: “The great physician would treat the patient with the disease while the good physician would treat the disease.” For me, this marches lock-step with the reality of today’s patient as consumer and active participant in the doctor-patient relationship. Simply put, it is impossible to separate the patient from a pre-conceived and often well-researched opinion — correct or not. So to treat the “patient with the disease” requires me to think of my patient as an intellectual partner. Read more »
What is a patient? What do they do? What’s their role in the doctor’s office? Are they chassis on a conveyor belt? Are they puzzles for doctors to solve? Are they diseases? Are they demographics? Are they a repository for applied science?
Or are they consumers? Are they paying customers? Are they the ones in charge? Are they employing physicians for their own needs?
It depends. It depends on the situation. It depends on perspective.
Some physicians are very offended when the “consumer” and “customer” labels are applied to patients. They see this as the industrialization of healthcare. We are no longer professionals, we are made into “providers” — sort of smart vending-machine made out of flesh.
Patients, on the other hand, get offended when doctors forget who pays the bill. They see the exam room as a right, not a privilege. They think they should be the most important person in the exam room, being treated with respect rather than having to bow at the altar of doctor knowledge.
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