Those darn patients…
Thursday, April 16 2009
In case you were wondering, a reader of Andrew Sullivan’s blog has finally nailed down what’s wrong with American healthcare:
American patients often come to the ER with very minor complaints – back pain for which they have not even tried tylenol, nasal congestion for two days, itchy mosquito bites, and so forth. All of them expect something from you, quickly, for their trouble – and it must meet their preconceptions or they will accuse you of ripping them off.
[...]
Ultimately, the American sense of entitlement, so long appeased and encouraged by our commercial culture, is what is poisoning the healthcare system.
So, there you have it: American patients and their sense of entitlement. That’s what’s wrong with our health care system, despite the fact that patients have almost no voice in that system. As a general rule, it is often true that when an institution is broken, the problem is the least powerful group of people in that particular sphere. The problem with slavery? Black people and their sense of entitlement. Women’s suffrage? Female people and their sense of entitlement. Child welfare? Tiny people and their sense of entitlement.
I don’t doubt this guy’s job (ER doc, apparently) is a drag. Yes, some patients are jerks, and those jerks can make life as a doctor a lot more frustrating than it ought to be. So what? Lots of people have to deal with jerks on a daily basis. The author at least takes some responsibility for that problem:
Doctors have played into it and are just as guilty for caving in when they know better, or billing for procedures a patient doesn’t really need. We have played along and made medical glitz into the standard of care, feeding and feeding off of a narcissism that cannot be satisfied.
The problem is, this guy wants to base health care policy on his gripes – on the patients he doesn’t like. But ostensibly, there are actually some patients who do need his help – you get the dimmest notion of such from his rant, but there have to be more than a few. The author is deliberately vague in his choice of words – “often”, “many”, “some”; he wants you to think this is a big, big problem, but still won’t quantify the problem. I’m going to go ahead and guess that the vast majority of patients he sees actually need his help (and aren’t jerks!).
So the question is, how many legitimate patients is this doctor willing to screw over, just to rid himself of the ones who don’t need his help? We can make our health care system impervious to jerks, but it’s also going to exclude a lot of legitimately sick and suffering people. That much is inevitable when you design an institution around the people who don’t need it, rather than those who do.
I think we should reform our health care system to meet the needs of sick people with a reasonable amount of fairness, efficiency, and effectiveness; obviously, this is my sense of entitlement, poisoning the system. But until anybody can demonstrate that most patients are jerks, we shouldn’t be blaming patients for what’s wrong with health care.
(Via Ezra Klein, who is poisoning the blogosphere with his sense of entitlement)
If you listened to the media and many doctors, you would think that the reason many hospitals have c-sections rates above 40% is because the women are demanding them, banging at the doors for their c-sections.
Patients are also blamed for being too old, too fat, too scared, too likely to sue if anything goes wrong… “The system” or “our litigious society” will also be blamed.
Want to know who is never, ever blamed in this scenario unless by patients’ rights advocates?
(The doctors performing too many c-sections)
Rather, it’s women’s sense of entitlement to a perfect baby that makes them have to perform unnecessary inductions and unnecessary cesareans to be able to show in court that they did *something.*
The doctors are the victims, you know. Not the women subjected to unnecessary major sugery that is riskier than the process that their body would perform on its own.