Life, Death and Healthcare - Doctors See Things Differently
There are worse things in life than death.
Have you ever spent an evening with an insurance salesman? - Woody Allen Medical students start seeing patients in their second year.
For a physics major, research geek like me, it was a major shock.
Not only was I pretty clueless about most of the diseases I ran into, I had much to learn about how to deal with people's emotions, expectations, and fears.
The professor I was assigned to at the time was an older, primary care physician.
He was a kind and caring man, with a large font of practical information about taking care of people.
At the time, I was planning to spend the next six years getting a PhD, and I wish I had paid him a little more attention.
One of the things he was fond of saying was "there are many things worse than dying", which in retrospect may be one of the most important things I have learned in my entire medical career.
Today's article reflects this knowledge(although the authors miss the main point).
The study discusses how doctor's care recommendations are different from what they would choose for themselves.
Doctors chose treatments for themselves which had a higher risk of death, but lower risk of complications, while recommending the opposite for their patients.
The authors, reporters and commentators seemed shocked about these findings.
How could doctors have the audacity to recommend different care for their patients than themselves? They suggest that doctors are out of touch with their patients feelings and desires, giving poor medical advice.
My interpretation is far different.
The default belief of many patients and families is "do everything" to keep someone alive at any cost.
Whether based upon religious conviction, forlorn hope, or ignorance of the possible negative outcomes, many non-physicians feel keeping people alive is more important than the quality of that life.
This position is understandable, without the experience that doctors have, one cannot be expected to reach this counter-intuitive conclusion.
However, those of us who have taken care of sick and dying patients have a much deeper appreciation of the misery and suffering that chronic disease and medical complications inflict upon both the patient and their families.
Physicians know that death may be preferable to many other outcomes, and this study discussed reflects that understanding.
The implications reach beyond medical ethics.
Huge amounts of medical care, and medical dollars, go toward keeping patients alive in the last few months of their lives.
The fundamental belief that life is worth maintaining at any cost is what underlies the justification for such futile care.
Doctors have lacked the moral courage to challenge the ignorance and institutional inertia that maintains the status quo.
We must realize that any successful healthcare reform must start with the truth about what doctors are actually doing.
The solution to our healthcare problems is not Obamacare, but being honest about our care.
http://www.
webmd.
com/news/20110411/double-standard-doctors http://www.
reuters.
com/article/2011/04/12/us-doctors-advice-life-idUSTRE73B0IZ20110412
Have you ever spent an evening with an insurance salesman? - Woody Allen Medical students start seeing patients in their second year.
For a physics major, research geek like me, it was a major shock.
Not only was I pretty clueless about most of the diseases I ran into, I had much to learn about how to deal with people's emotions, expectations, and fears.
The professor I was assigned to at the time was an older, primary care physician.
He was a kind and caring man, with a large font of practical information about taking care of people.
At the time, I was planning to spend the next six years getting a PhD, and I wish I had paid him a little more attention.
One of the things he was fond of saying was "there are many things worse than dying", which in retrospect may be one of the most important things I have learned in my entire medical career.
Today's article reflects this knowledge(although the authors miss the main point).
The study discusses how doctor's care recommendations are different from what they would choose for themselves.
Doctors chose treatments for themselves which had a higher risk of death, but lower risk of complications, while recommending the opposite for their patients.
The authors, reporters and commentators seemed shocked about these findings.
How could doctors have the audacity to recommend different care for their patients than themselves? They suggest that doctors are out of touch with their patients feelings and desires, giving poor medical advice.
My interpretation is far different.
The default belief of many patients and families is "do everything" to keep someone alive at any cost.
Whether based upon religious conviction, forlorn hope, or ignorance of the possible negative outcomes, many non-physicians feel keeping people alive is more important than the quality of that life.
This position is understandable, without the experience that doctors have, one cannot be expected to reach this counter-intuitive conclusion.
However, those of us who have taken care of sick and dying patients have a much deeper appreciation of the misery and suffering that chronic disease and medical complications inflict upon both the patient and their families.
Physicians know that death may be preferable to many other outcomes, and this study discussed reflects that understanding.
The implications reach beyond medical ethics.
Huge amounts of medical care, and medical dollars, go toward keeping patients alive in the last few months of their lives.
The fundamental belief that life is worth maintaining at any cost is what underlies the justification for such futile care.
Doctors have lacked the moral courage to challenge the ignorance and institutional inertia that maintains the status quo.
We must realize that any successful healthcare reform must start with the truth about what doctors are actually doing.
The solution to our healthcare problems is not Obamacare, but being honest about our care.
http://www.
webmd.
com/news/20110411/double-standard-doctors http://www.
reuters.
com/article/2011/04/12/us-doctors-advice-life-idUSTRE73B0IZ20110412
Source...