Guest guest Posted October 13, 2009 Report Share Posted October 13, 2009 > I present this article from the EMED-L list, without comment, for your > consideration. > > GG > > with apologies to Doc Holiday and all my non-American colleagues.... > > We have become a nation of whining hypochondriacs, and the only way to fix > a broken health-care system is for all of us to get a grip, says DR. > THOMAS > A. DOYLE > Sunday, October 11, 2009 > Pittsburgh Post-Gazette > Emergency departments are distilleries that boil complex blends of trauma, > stress and emotion down to the essence of immediacy: What needs to be > done, > right now, to fix the problem. Working the past 20 years in such > environments has shown me with great clarity what is wrong (and right) > with our > nation's medical system. > It's obvious to me that despite all the furor and rancor, what is being > debated in Washington currently is not health-care reform. It's only > health-care insurance reform. It addresses the undeniably important issues > of who is > going to pay and how, but completely misses the point of why. > Health care costs too much in our country because we deliver too much > health care. We deliver too much because we demand too much. And we demand > it > for all the wrong reasons. We're turning into a nation of anxious wimps. > I still love my job; very few things are as emotionally rewarding as > relieving true pain and suffering, sharing compassionate care and actually > saving > lives. Illness and injury will always require the best efforts our medical > system can provide. But emergency departments nationwide are being > overwhelmed by the non-emergent, and doctors in general are asked to treat > what > doesn't need treatment. > In a single night I had patients come in to our emergency department, most > brought by ambulance, for the following complaints: I smoked marijuana and > got dizzy; I got stung by a bee and it hurts; I got drunk and have a > hangover; I sat out in the sun and got sunburn; I ate Mexican food and > threw up; I > picked my nose and it bled, but now it stopped; I just had sex and want to > know if I'm pregnant. > Since all my colleagues and I have worked our shifts while suffering from > worse symptoms than these (well, not the marijuana, I hope), we have > understandably lost some of our natural empathy for such patients. When > working > with a cold, flu or headache, I often feel I am like one of those cute > little > animal signs in amusement parks that say " you must be taller than me to > ride > this ride " only mine should read " you must be sicker than me to come to > our > emergency department. " You'd be surprised how many patients wouldn't > qualify. > At a time when we have an unprecedented obsession with health (Dr. Oz, > " The Doctors, " Oprah and a host of daytime talk shows make the smallest > issues > seem like apocalyptic pandemics) we have substandard national wellness. > This > is largely because the media focuses on the exotic and the sensational and > ignores the mundane. > Our society has warped our perception of true risk. We are taught to fear > vaccinations, mold, shark attacks, airplanes and breast implants when we > really should worry about smoking, drug abuse, obesity, cars and basic > hygiene. > If you go by pharmaceutical advertisement budgets, our most critical > health > needs are to have sex and fall asleep. > Somehow we have developed an expectation that our health should always be > perfect, and if it isn't, there should be a pill to fix it. With every > ache > and sniffle we run to the doctor or purchase useless quackery such as the > dietary supplement Airborne or homeopathic cures (to the tune of tens of > billions of dollars a year). We demand unnecessary diagnostic testing, > narcotics > for bruises and sprains, antibiotics for our viruses (which do absolutely > no > good). And due to time constraints on physicians, fear of lawsuits and the > pressure to keep patients satisfied, we usually get them. > Yet the great secret of medicine is that almost everything we see will get > better (or worse) no matter how we treat it. Usually better. > The human body is exquisitely talented at healing. If bodies didn't heal > by themselves, we'd be up the creek. Even in an intensive care unit, with > our > most advanced techniques applied, all we're really doing is optimizing the > conditions under which natural healing can occur. We give oxygen and > fluids > in the right proportions, raise or lower the blood pressure as needed and > allow the natural healing mechanisms time to do their work. It's as if you > could put your car in the service garage, make sure you give it plenty of > gas, > oil and brake fluid and that transmission should fix itself in no time. > The bottom line is that most conditions are self-limited. This doesn't > mesh well with our immediate-gratification, instant-action society. But > usually > that bronchitis or back ache or poison ivy or stomach flu just needs time > to get better. Take two aspirin and call me in the morning wasn't your > doctor > being lazy in the middle of the night; it was sound medical practice. As a > wise pediatrician colleague of mine once told me, " Our best medicines are > Tincture of Time and Elixir of Neglect. " Taking drugs for things that go > away > on their own is rarely helpful and often harmful. > We've become a nation of hypochondriacs. Every sneeze is swine flu, every > headache a tumor. And at great expense, we deliver fantastically prompt, > thorough and largely unnecessary care. > There is tremendous financial pressure on physicians to keep patients > happy. But unlike business, in medicine the customer isn't always right. > Sometimes a doctor needs to show tough love and deny patients the quick > fix. > A good physician needs to have the guts to stand up to people and tell > them that their baby gets ear infections because they smoke cigarettes. > That > it's time to admit they are alcoholics. That they need to suck it up and > deal > with discomfort because narcotics will just make everything worse. That > what's really wrong with them is that they are just too damned fat. > Unfortunately, this type of advice rarely leads to high patient > satisfaction scores. > Modern medicine is a blessing which improves all our lives. But until we > start educating the general populace about what really affects health and > what a doctor is capable (and more importantly, incapable) of fixing, we > will > continue to waste a large portion of our health-care dollar on treatments > which just don't make any difference. > > Read more: > http://www.post-gazette.com/pg/09284/1004304-109.stm#ixzz0TjPscpNR > > > > > > > > -- > Quote Link to comment Share on other sites More sharing options...
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