Here is a great article from an ER doc. His name is Thomas Doyle MD and he has a book coming out called “Suck It Up, America: The Tough Choices Needed for Real Health-Care Reform”. I highly recommend you read the linked piece but he hits a lot of great points. Here is a quick summary:
- Healthcare costs too much in our country because we deliver too much healthcare. We deliver too much because we demand too much. And we demand it for all the wrong reasons. We’re turning into a nation of anxious wimps.
- In a single night I had patients come in for the following complaints (all brought by ambulance): “Smoked marijuana and got dizzy”, “stung by a bee and it hurts”, “got drunk and have a hangover”, “sat out in the sun and got sunburn”, “ate Mexican food and threw up”, “picked my nose and it bled, but now it stopped”, “just had sex and want to know if I’m pregnant.”
- Our society has warped our perception of true risk. We are taught to fear vaccinations, mold, shark attacks, airplanes and breast implants when we really should worry about smoking, drug abuse, obesity, cars and lack of basic hygiene.
- Somehow we have developed an expectation that our health should always be perfect. We demand unnecessary diagnostic testing, antibiotics for our viruses, narcotics for bruises and sprains. And due to time constraints on physicians, fear of lawsuits and the pressure to keep patients satisfied, we usually get them.
- The bottom line is that most conditions are self-limited. “Our best medicines are Tincture of Time and Elixir of Neglect.”
- There is tremendous financial pressure on physicians to keep patients happy. But unlike business, in medicine the customer isn’t always right. Sometimes a doctor needs to show tough love and deny patients the quick fix. A good physician needs to have the guts to stand up to people and tell them that their babies gets ear infections because they smoke cigarettes. That it’s time to admit they are alcoholics. That they need to suck it up and deal with discomfort because narcotics will just make everything worse. That what’s really wrong with them is that they are just too damned fat. Unfortunately, this type of advice rarely leads to high patient satisfaction scores.