This blog author uses more rhetoric
than anything to push for a single payer system. She tries to
convince us that it is not the government that comes between us and
our doctors.
The agencies, organizations, and others
that make it difficult for patients and doctors includes the
following:
#1. The government The
Department of Health and Human Services (HHS), the Centers for
Medicare and Medicaid Services (CMS) are just two of the government
agencies that are creating problems and coming between patients and
doctors. CMS is mandating, especially for
seniors, what can't be spent for medical necessities when this may be
the only thing that will save a life. I am not talking about those
near the end of life, but those that could be treated and have
quality of life for many more years. The government agencies issue
new regulations that create more paperwork. This in turn reduces the time for
doctors that they have for spending with patients.
#2. State Medical Boards and
Medical Associations They help limit beneficial programs and
work to promote faulty medical guidelines that the doctors have to
follow. They lobby state legislatures to hobble new forms of medical
practice like telemedicine and practice across state lines.
#3. The insurance industry
Since managed care and pre-approvals came into existence more than 20
years ago, the insurers have delayed doctor treatments. And I mean
in the emergency department and for operations. The insurers move
drugs in and out of their formularies to reduce expenses. They have
to keep their profit margin don't they? The worst part is they
follow what CMS does and almost lock-step.
If isn't one of the above, its another.
There could be other agencies and medical groups involved, but these
are the main cast of characters. Now we arrive at the supporting
characters.
a. The medical schools The
doctors will deny this, but the medical schools do not teach some of
the skills needed by doctors. Communication is a missing topic, the
importance of the patient is also missing. Doctors graduate thinking
they are god-like and infallible and that patients should rely on
them as the source of all knowledge about what ails them. They can't
explain things coherently to the patient or the patient's family.
The doctors can only use medical terms and wonder why the patients do
not understand them.
Then when the patients desire to have
some part in their treatment, the doctor gets all up-tight and won't
listen to their wishes. When the doctor writes a prescription, he
expects the patient to fill the prescription and take it per
directions. However, the doctor does not explain what the medication
is, any side effects to watch for and what to do when they happen.
When the patients asks questions, the doctor becomes angry that any
patient would question him. All the courtesies are not part of the
education doctors receive and some would ignore this anyhow.
b. The doctors themselves And
you thought I had said enough about doctors. There are a few good
doctors and even fewer great doctors. If doctors did not have this
big fear of patients, they would not need to practice defensive
medicine. It is their complete lack of communication that makes
patients wonder what they are hiding and why. The doctor-patient
trust is lacking and when patients are suspicious, everything a
doctor does is analyzed.
c. The patients and their families
How I hate saying this, but sometimes patients can be their own
worst enemy. Also, when a spouse becomes too insistent, then the
best doctor/patient relationship is in jeopardy. Even the best
defensive medicine won't work when a spouse thinks something is
amiss.
It is really a shame the when everyone
points a finger at someone, they don't realize that they have three
fingers pointing at back at them. There is a lot of blame to go
around and each character plays a part.
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