tag:blogger.com,1999:blog-7323692122514281455.post6172531863558328048..comments2024-03-29T09:01:51.993-04:00Comments on MD Whistleblower: Where Have All the Bedside Manners Gone?Michael Kirsch, M.D.http://www.blogger.com/profile/07555280388086931097noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-7323692122514281455.post-20839544963052418052010-11-09T00:06:39.907-05:002010-11-09T00:06:39.907-05:00People are varied, unpredictable and fascinating. ...People are varied, unpredictable and fascinating. One should not judge them or try to reform them but understand them. You must show them that you really and honestly care for them by co-operating willingly with them and giving more, talking little. You will become vital to others if they could thus see your selfless interest in them.List of Good Mannershttp://life-etiquette-manners.blogspot.com/2010/02/about-secrets-inspirational-life-dont.htmlnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-24740166739403704752010-06-01T02:13:23.589-04:002010-06-01T02:13:23.589-04:00I think that bedside manner went out the door when...I think that bedside manner went out the door when patients began to be forced to have amnesia drugs. I mean, what's the point if the patient is going to be a zonked out zombie? They won't remember it anyway (many do) so who cares? I hope that "cost effectiveness" will get an iron grip on frivolous sedation.Never Againhttps://www.blogger.com/profile/00809517208101930723noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-29912509555580659022009-12-28T20:51:13.186-05:002009-12-28T20:51:13.186-05:00Thanks Jeff. I don't think that bedside manne...Thanks Jeff. I don't think that bedside manner issues are part of health care reform (HCR). As I noted in the post, I fear that HCR may further threaten the doctor-patient relationship.Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-24451555314701120022009-12-28T17:58:59.279-05:002009-12-28T17:58:59.279-05:00Thanks for a fine essay, especially your compassio...Thanks for a fine essay, especially your compassion for your long-suffering colleagues.<br /><br />Jeff Kane MD<br />healthcareasthoughpeoplematter.blogspot.comAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-86751007350400495052009-12-13T11:40:00.924-05:002009-12-13T11:40:00.924-05:00@Evinx: The idea of single-payer, as you know, is ...@Evinx: The idea of single-payer, as you know, is that the government functions as the insurance company. In the public option proposal there would be premiums paid, but the government would write the checks.<br /><br />In my reading, the single-payer systems are doing well and patients get better care than in the US at half the per-capita cost. Moreover, patients in those countries LIKE the system. And, on the whole, they live longer and experience lower infant mortality than in the US. <br /><br />You need to do more study of the issue and the possible solutions.LeisureGuyhttps://www.blogger.com/profile/05962143066390145440noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-58501035917989649232009-11-15T22:39:05.978-05:002009-11-15T22:39:05.978-05:00Nice article. This goes right along with a book I&...Nice article. This goes right along with a book I'm reading called <a href="http://normanmakous.com/" rel="nofollow">"Time to Care"</a> by Norman Makous, M.D. The book advocates that the doctor-patient relationship has deteriorated over the decades as the growth of technology has skyrocketed. He believes the relationship is a critical part of understanding the patient’s medical situation, making a diagnosis, and applying effective treatment. I learned the difference between individualized medicine and truly personal medicine.Bettyhttps://www.blogger.com/profile/04268833309327426333noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-35527144626016906632009-11-11T12:09:31.652-05:002009-11-11T12:09:31.652-05:00Left Eyed Jack
I agree - there is lots imperfect w...Left Eyed Jack<br />I agree - there is lots imperfect with our current system. However, that does not mean a single payer system would be any better. That was my argument. In fact, imo, it will be far, far worse. Since when have Americans thought monopoly/monopsony power is a good thing?<br /><br />We need more options - not fewer. We need more flexibility - not fewer. I used to live in NY where my policy was over $1200/mo. Simply by moving, my premium was able to go to $279/mo. There are lots of state mandates that raise the cost of insurance. There are states with community rating which greatly increases premiums. There are lots of restrictions on the interstate sale of health insurance which limits our options and raises premiums.<br /><br />The single payer solution is not increasing options + not allowing for more flexibility. The devil is in the details.Evinxnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-50313443037848157762009-11-10T15:06:51.523-05:002009-11-10T15:06:51.523-05:00It is easy to complain about all the problems we g...It is easy to complain about all the problems we get when we call government "help lines." BUT while trashing one system, let's not overlook the EXACT same problems in the other. I have had the "thrill" of trying to talk to my insurance company, back when I had insurance, and the experience was exactly the same as you complain of. There's nothing more infuriating than having your doctor finally find a medication that addresses a problem you're having and then having the insurance company denying your access to it. Let's not pretend that all the scary things that are being put out there against a government option plan don't already exist in plentiful quantities in the private health care "system" that SOME of us have access to now.<br /><br />Some of us do not have access to health care because we need insurance, and all the yammering about the harmful maybes that might come to everybody else is leaving many of those in need with NOTHING! It's easy for those with health care insurance to cast stones at a system that appears to be all the rest of us have any hope of getting.<br /><br />It must be nice, indeed, not to have the problems that nearly 40% of all Americans are having to live with every day.<br /><br />How about a little generosity of spirit?Left-Eyed Jackhttp://lefteyeonthemedia.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-64480951973672899442009-11-09T12:36:20.619-05:002009-11-09T12:36:20.619-05:00LG
The article you cited is all anecdotal.
You a...LG<br /><br />The article you cited is all anecdotal.<br /><br />You are ignoring policy implications. BTW, I have read about the French + Swiss + UK system. One problem with single payor is it is a political system - every special interest group lobbies to have their procedures included in the base coverage. That is why the Swiss system + the French (forget about the UK system) are starting to break apart at the seams.<br /><br />Did you know that prayer is now included in the newest House bill just passed this past weekend? READ just parts of the bill - I am sure you will not be able to comprehend huge parts of it. READ some of the Federal Register. It is gobbledegook - and I am a post graduate from one of the more prestigious unversities in the country.<br /><br />Single Payor is a simplistic approach but ultimately, there are no free lunches. Somebody has to pay - and bureaucratic committees do the ratioing. If you do not allow a price mechanism to allocate goods and services, you then subscribe to bureaucrats - who do it via directives in the Federal Register or legislation.<br /><br />And if you do not like the govt rationing, where do you go? In the UK, if you want to pay for some test or procedure on your own, you have to forgo ALL other govt paid medical services forever. So you cannot.<br /><br />The current system is far from perfect but at least you have options. With S/P, you're lucky if they answer the phone.Try calling Medicare (as I have) just to ask about billing. Or call the IRS about tax questions. Did you know 43% of the answers IRS personnel give are WRONG? And even with wrong advice from the IRS, you still are responsible. Is that what you are advocating for?Evinxnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-92064524294460403172009-11-07T16:05:52.819-05:002009-11-07T16:05:52.819-05:00Agree with LeisureGuy. Doctors have too much discr...Agree with LeisureGuy. Doctors have too much discretion to decide what they will and won't do. That leaves patients with difficult diagnoses "pretty much nowhere," without even a referral, as my family doctor put it.<br /><br /> Malpractice "unfairness" becomes just a cover for doctors' cherry-picking. "You look fine" just doesn't cut it in terms of diagnostics. Why can't we strive for Marcus Welby with House's skills?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-68983275028606489222009-11-07T13:12:40.852-05:002009-11-07T13:12:40.852-05:00I am being straightforward, and I suggest some rea...I am being straightforward, and I suggest some reading for you on how single-payer healthcare systems work in France, Germany, and other advanced countries. There is no billing, for one thing, and there are no insurance companies to deal with. Can you get your head around that?<br /><br />And so far as tort "reform" is concerned, I highly recommend <b>this article</b>: http://bit.ly/2VQbNaLeisureGuyhttps://www.blogger.com/profile/05962143066390145440noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-88807925891184795232009-11-06T15:15:45.554-05:002009-11-06T15:15:45.554-05:00LG
"It's interesting that some of the pro...LG<br />"It's interesting that some of the problems you cite (battling insurance companies to get payment and mounds of paperwork, for example) are absent in countries that use a single-payer-based national healthcare system: no insurance companies enter the picture, and no billing and thus an enormous reduction in paperwork."<br /><br />On the surface, this makes no sense. Govt is known for its confusing regulations and paperwork. Have you ever completed a tax return?<br />Have you read some regulations in the Federal Register?<br />Have you read even part of the 1990 page House bill soon to be voted on?<br />If you want to advocate for single payer, fine - but at least be straight-forward about it.Evinxnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-28179798076850762812009-11-02T20:00:24.238-05:002009-11-02T20:00:24.238-05:00Like your blog that was on kevinmd - can I use it ...Like your blog that was on kevinmd - can I use it with you permission and name on my blog (your authorship for complete credit is what I mean)? <br /><br />docchat.wordpress.com<br /><br />Thanks.<br />Robert Sadaty MDAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-85847256393385385522009-11-01T10:45:37.808-05:002009-11-01T10:45:37.808-05:00It's interesting that some of the problems you...It's interesting that some of the problems you cite (battling insurance companies to get payment and mounds of paperwork, for example) are absent in countries that use a single-payer-based national healthcare system: no insurance companies enter the picture, and no billing and thus an enormous reduction in paperwork. <br /><br />And, of course, from a consumer view, the medical malpractice system doesn't seem all that unfair when you look at the specifics of the cases that go to outcome. The most comprehensive solution to that problem is to reduce the instances of malpractice, and a lot of that can clearly be done by removing from the system the doctors who are most frequently guilty of malpractice. Other steps---using checklists, designing more informative packaging that clearly signal the meds they contain, and so on---could take care of most of the rest.LeisureGuyhttps://www.blogger.com/profile/05962143066390145440noreply@blogger.com