Sunday, June 08, 2014

When the worst medical advice comes from the patient

When the patient plays doctor, good healthcare can be the loser

Karen Ravn, LA Times

In the ongoing debate over how healthcare decisions ought to be made, doctors are generally seen as the ones running the show — the ones who decide who does the deciding. But it doesn't always work that way. Sometimes patients hijack the whole process.

True story: A fellow with a cold came to see Dr. John Santa asking for antibiotics. Santa carefully explained that antibiotics wouldn't do the man any good because his cold was caused by a virus, and antibiotics only work on bacterial infections. The patient stomped out of the office, fulminating bitterly as he went: "If you weren't going to give me antibiotics, why did you see me?"

In the doctor-patient relationship, patients, naturally enough, are considered the experts on their own personal beliefs and views, life styles and circumstances, but doctors are generally considered the experts on medical issues. As seen from the antibiotics brouhaha, though, patients aren't always content to stick to their own bailiwick.

And, in fact, Santa's disgruntled patient was far from unique. Every day, in offices all around the country, other patients request antibiotics that will do them no good, and all too often their doctors, unlike Santa, prescribe them. "Sadly, the easiest solution, rather than to just say no and potentially anger the patient, is to do what they ask," says Santa, now the director of the Consumer Reports Health Ratings Center. "That is why antibiotics are overused."

(More here.)


Blogger Minnesota Central said...

A sidenote to this story is the advertising ... turn on your nightly news and the main advertisers are medical device and drug companies.

What got me was when I picked up the April 28th edition of Time and found a three-page ad for Sovaldi ... with the caption "I Am HEPATITIS Cured" ... and the "groundbreaking treatment called Sovaldi".
No where does it tell you the cost ... the basic treatment plan is $84,000 plus side-drugs for another $9,0000 ... and Medicare just approved its use.
The problem is that the US has no negotiation powers with the drug ... in the UK, the price is US$57,000 and in Germany the price is US$66,000 but India is looking at a generic with a targeted cost of $4,000. Many times the treatment is twice ... meaning $168K.

Congress needs to hold hearings on this.

6:10 PM  

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