Skip to main content

Leave No Patient on the Battlefield.

Image
By
Despite our professed values, everything has a price.

We value life, but our society is unwilling to lower the highway speed limit to 40 mph, which would surely save lives.  The price of our collective inconvenience and economic impact is too high.

Lower Speed Limit and Save Lives?

We leave no soldier on the battlefield, but this military value cannot be viewed in isolation.  We are told this week by our commander-in-chief and his acolytes that rescuing a captured soldier is worthy regardless of the price.  We are told that negotiating with terrorists, breaking the law by not notifying congress and the release of 5 hardened Taliban detainees is a reasonable price for the return of a captured sergeant.    I feel that the price exacted was too high, although admittedly my view would be different if the sergeant were in my family.  For those who argue that no price is too high to rescue one of our own, should we have surrendered to the Nazis in World War II in return for some captured U.S. soldiers?   So, the noble principle of leaving no soldier on the battlefield is not absolute and needs context.

We want a secure nation, but at what price?  There’s a tension in America between security and civil liberties that is ongoing.  North Korea is a very secure state, but we wouldn’t be willing to pay the price that Korean citizens are forced to pay.  We willingly tolerate some level of insecurity here in order to preserve our personal freedoms and rights. 

We strive for quality medical care for all, but at what price?  We expect timely access to medical specialists, diagnostic testing on demand, the newest medications, affordable prescriptions and second opinions on request.  We don’t object to the price as someone else is picking up the bill.   If we were paying the tab ourselves, would we do so willingly and enthusiastically?  And the aggregate cost of rampant over-diagnosis and over-treatment affects every one of us.  Decades of draining the system and providing medical care without limit and spending more money per capita than other nations that have healthier citizenry have exacted a heavy price called Obamacare. 

Like the military, we aim to rescue every patient.  But, can we?  What are we willing to give up to accomplish this mission?
Labels:

Comments

  1. Akmos17June 10, 2014 at 5:45 AM

    Decades of draining the system and providing medical care without limit and spending more money per capita than other nations that have healthier citizenry have exacted a heavy price called Obamacare. aimbot for bf4

    ReplyDelete
  2. Medical MojaveJune 12, 2014 at 12:00 PM

    My husband and I discuss this a lot as I am, unfortunately, a heavy user of the health care system. The ACA isn't the final answer, it's a piece.

    But politics are so bad now, I don't know that we'll ever get a workable system. Probably not in my lifetime.

    My one thought is to push for everyone to have the ability to set up an HSA regardless of their health insurance plan (or lack thereof). Stopping tying it to specific plans. Let us save the money we're going to need. Let us set up HSA's for our kids a la the 529 plans for education that they can take into adulthood.

    Because ACA provides insurance, but still leaves patients financially vulnerable.

    Beyond that suggestion, I have no idea how we're going to fix this mess. The system didn't work before and it doesn't work now. There are too many competing interests for any effective change imo.

    ReplyDelete

Post a Comment

Popular posts from this blog

Becoming a Part-Time Physician

By
Next month my schedule will change.  I will henceforth be off on Fridays with my work week truncated to Monday through Thursday.   I am excited to be enjoying a long weekend every weekend.  And while the schedule change is relatively minor, this event does feel like an important career moment for me.  It is the first step on a journey that will ultimately lead beyond my professional career.  It is this recognition that makes this modest schedule modification more significant than one would think it deserves.  As some readers know,   my current employed position has been a dream job for me.   Prior to this, I was in a small private practice, which I loved, but was much more challenging professionally and personally.   My partner and I ran the business.   Working nights, weekends and holidays were routine for decades.   On an on-call night, if I slept  through until morning, I felt as if I had won the lottery.   And w...
15 comments
Read more

When Should Doctors Retire?

By
I am asked with some regularity whether I am aiming to retire in the near term.  Years ago, I never received such inquiries.  Why now?   Might it be because my coiffure and goatee – although finely-manicured – has long entered the gray area?  Could it be because many other even younger physicians have given up their stethoscopes for lives of leisure? (Hopefully, my inquiring patients are not suspecting me of professional performance lapses!) Interestingly, a nurse in my office recently approached me and asked me sotto voce that she heard I was retiring.    “Interesting,” I remarked.   Since I was unaware of this retirement news, I asked her when would be my last day at work.   I have no idea where this erroneous rumor originated from.   I requested that my nurse-friend contact her flawed intel source and set him or her straight.   Retirement might seem tempting to me as I have so many other interests.   Indeed, reading and ...
69 comments
Read more

Personal Responsibility for Health

By
One of the advantages of the computer era is that patients and physicians can communicate via a portal system.  A patient can submit an inquiry which I typically respond to promptly.  It also offers me the opportunity to provide advice or test results to patients.  Moreover, the system documents that the patient has in fact read my message.  Beyond the medical value, it also provides some legal protection if it is later alleged that ‘my doctor never sent me my results’.  I have always endorsed the concept that patients must accept personal responsibility.   Consider this hypothetical example. A patient undergoes a screening colonoscopy and a polyp is removed.   The patient is told to expect a portal message detailing the results in the coming days.   Once the analysis of the polyp has been completed, the doctor sends a message via the portal communicating that the polyp is benign, but is regarded as ‘precancerous'.   The patient is advise...
3 comments
Read more