I can only guess why things went as they did in this patient's encounter. A number of motivations come to mind which are too numerous to describe here. She points out, however something I have noted which is that some of my colleagues have become experts at gaming a system that rewards for doing more. One sign of a person's shift from compassionate care is a doc's shift in everyday conversation from care issues to material things or money-making schemes.
A system that rewards one for the skill in handling cases, outcomes, interpersonal skills and all the things desired in a "good doctor" would be ideal but hard to develop. Attempts are being made to incorporate this but with little data to support the metrics so it is a little scary for the average doc who just wants to give good care. Best, I think, would be to support and incorporate the best models out there, such as at the Cleveland Clinic where doctors are salaried and not paid by production and number of procedures.
I am in emergency doctor. I don't do "wallet biopsies" and can't (and don't want to) choose my patients. I like that but is is not for everyone. Most emergency docs burn out and retire or move to something else by my age. My heart goes out for patients with limited means and I will game the system to save them a few bucks. Universal healthcare would solve that problem. Obamacare is only a start. It has deep flaws and will get bad publicity but keep aware of developments and lobby your representatives to improve it. Be aware that corporate interests are always trying to improve their bottom lines so look at where their lobbying money goes and press for alternatives. It's tiring but eternal vigilance is more important now than ever.
There are many such hidden groups (and I beleive thay are hate groups) that have been around for 40+ years, all because people like Koch's daddy become less relevant when his John Birch crumbled. Koch daddy and his boys then began their crusade to control churches, people and then governments after they hated Eisenhower building the middle class/closing the gap between the rich/poor. So we try to make ALEC less powerful, the .1%ers will just move more $$ into one of these other groups. We must be viligant!
I've noticed an interesting trend in pharmaceutical advertising in recent years, which was not mentioned in your otherwise excellent article.
First, there is a happy, glittering, and colorful commercial for a new medicine. Typically, the first version doesn't state what the medicine is for, just naming it and showing happy people dancing in fields, or some such. "Ask your doctor if --- is right for you," the ads usually end.
In the second stage, the use of the drug is emphasized, with long lists of side effects thrown at the end of each ad. It is a film rendition of the slick ads published in doctors' magazines.
In the third stage, patients and their families have mobilized, brought suit, and urged the FDA to ban the drug. The ads now are less glittery, and are now purchased by law firms hoping to attract clients whose lives were ruined or ended by taking the drug.
Am I the only one who has noticed this interesting trend?
Thank you for this article. If SPN's agenda is as you outlined, then I support them completely. I recommend www.discoverthenetworks.org to anyone wanting to explore the extensive organizations the radical left/progressives have established over many decades. Just plug in an organization (e.g., Tides Foundation, Joyce Foundation) and see the spiderweb. Far more extensive and far better funded than anything conservatives have set up. The left has more billionaires funding them -- "evil" businessmen all of them too (Soros, Bloomberg, etc.). The left has perfected the disgracefull grabbing of tax dollars for their own use. Think about it - trillions of dollars have gone to Great Society / anti-poverty programs yet poverty is worse than ever. Only the organizations benefitted. Their efforts have miserably failed so why keep pooring tax dollars into them? Answer: The left's agenda is to take tax dollars for themselves. The only "fairness" they support is taking your money for themselves. Wake up people. Thanks again for the article. I will now support SPN.
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