Avoiding Patients – How Docs Defend It

Paternalism

I convinced myself I was dying of prostate cancer last year.  Turns out, I was drinking too much coffee.

Patients often seek help for things that turn out to be pretty simple.

They laugh afterwards.

Phew!

Thank God it wasn’t cancer.

Many physicians sincerely believe that their staff can safely dismiss a patient’s concern over the phone, or put off seeing a patient for days (or weeks!).

By the time someone has ramped up the courage to seek help, his anxiety has peeked; he can’t take it any longer.

Patients finally give in and get seen; like Lightning McQueen finally going to buy some tires in Cars:

Lightning McQueen:  All right, Luigi, give me the best set of black walls you’ve got.

Luigi:  No, no, no!  You don’t know what you want!  Luigi know what you want!

Avoiding Patients

When patients want to be seen in the office that day, physicians argue that:

  • They know it’s not a serious problem.
  • They know it can wait.
  • They know the patient will be fine.
  • They know best.

Patients often think they need medical help when there’s nothing medically serious going on.

But, unless physicians get radically committed to understanding and meeting the perceived needs of patients, medicine will lose the privilege of caring for patients’ concerns or be tolerated begrudgingly until some better option comes along.

How soon would you like to see your family doctor if you called for something that really worried you?  Do you like getting a “We know best” attitude?  Do you like having to worry while you wait for an appointment?

Medicare vs. Patient Care

i_love_medicare_stickerConference participants wore ‘I Love Medicare’ pins in Calgary.

Nietzsche might ask

Do you love medicare because patients benefit, or do you love medicare because you benefit?

Do you love ‘free care’ more than patient care?

People can care more about the idea of universal health care than they do about the care patients receive.

They deny data showing

long waits

poor patient outcomes

lack of access

lack of coordination

high cost

inefficiency

lack of control

provider frustration

Their solutions focus on

more control

more funding

more rationing

more cuts to salaries > 100k

more patient education to divert access

They would rather fight for a failed system than fight for improved patient care.

dog-ma-tism

n. An arrogant, stubborn assertion of opinion or belief

dog-ma-tism n.

1. positiveness in assertion of opinion especially when unwarranted or arrogant

2. a viewpoint or system of ideas based on insufficiently examined premises

Medicare dogmatism will guarantee mediocrity at best.

We need a system that:

puts patients’ needs first

makes patient experience central to funding

gives patients great access

offers patient choice

guarantees quality care (Quality should be a given)

demonstrates business excellence

attracts the best leaders

rewards great outcomes; not mediocrity

aligns incentives for every provider

rewards grass-roots provider innovation

gives control to health-care experts

This can happen in a publicly funded system, but it will never happen if people resist change.

We need to stop thinking that health-care is so special, complicated and unchangeable.

Do we love medicare more than patient care? Can we have an adult conversation about change?  What do you think?