Ten Simple Rules

[asterism]

It's inane:

(8) Current: The system reacts to needs. New: Needs are anticipated. The health care system should anticipate patients’ needs rather than simply reacting to events.


WTF does this mean? Is the health care system supposed to be able to predict who might get cancer and need treatment? Or know when one may be in a care accident?

It's a bunch of feel good nonsense dreamed up by utopian bureaucrats who are willing to destroy what works in order to replace it with their version of the way they think we should live.

Here's the translation of that concept into a real world example:

"I think Mrs. XXXXXX is going to have a bad night"

"Well then we should sedate her now so she just sleeps through it."

----in the morning-----

"Well, it seems she had a bad night and had to be sedated so we're going to skip the physical therapy today and give her time to recover."

-------in the evening-----


"She's just not doing well. She wasn't even well enough to do physical therapy today even after we made sure she got the rest she needed."

"She doesn't need rest, she needs exercise."

"But she can't do it, see? She got sedated last night."





But I'm sure you think this is somehow better. After all, this was 2 years ago and according to these "patient-centered" studies my mom should be dead now.

 

[Quantum Windbag]

See how the arrogant Liberal control freak responds to valid complaints about his "ideas"? Instead of explaining himself and his moronic ideas further he falls back to that lazy old excuse of "Well, you're just too stupid to understand!"

In fairness, when someone asks if using technology to grant patients 24-hour access to medical professionals implies clairvoyance about "know[ing] when one may be in a care [sic?] accident?," declares that proposing patients define their needs is another way of suggesting bureaucrat-helmed death panels, and implies that HSA funds don't roll over from one year to the next or that tort reform isn't specifically endorsed in the article this thread is about, there actually is a chance they're simply not intellectually equipped to handle some of the concepts here.

I'd first chalk it up to partisanship and ideological blindness but it's worth exploring all the possibilities.

I have a question for the panel of posters that post under you name.

Why should doctors be available at my beck and call 24 hours a day? How do you expect doctors to get any sleep when they have to respond to their patients 24 hours a day. What more than one of my doctors 400 patients need to talk to him at the same time, will the government clone him?

The system you laid out is wonderful is known in the real world as utopian. In case you do not understand what that means, it is ideal. It would be wonderful to see an ideal, but only idiots believe we will ever have it.

Are you an idiot?

 

[Greenbeard]

Here's the translation of that concept into a real world example:

"I think Mrs. XXXXXX is going to have a bad night"

"Well then we should sedate her now so she just sleeps through it."

----in the morning-----

"Well, it seems she had a bad night and had to be sedated so we're going to skip the physical therapy today and give her time to recover."

-------in the evening-----


"She's just not doing well. She wasn't even well enough to do physical therapy today even after we made sure she got the rest she needed."

"She doesn't need rest, she needs exercise."

"But she can't do it, see? She got sedated last night."


But I'm sure you think this is somehow better. After all, this was 2 years ago and according to these "patient-centered" studies my mom should be dead now.

I think you're missing the point, though I commend you for being the first person to approach the concepts here from a non-ideological perspective.

What you're describing is not patient-centered care. The particular principle from the article that's relevant to your example is:

(3) Current: Professionals control care. New: The patient is the source of control. Patients should be given the necessary information and the opportunity to exercise the degree of control they choose over the decisions that affect them. The health care system should be able to accommodate differences in patients’ preferences and encourage shared decision making. (I interpret this to mean that "permission" begins in the patient’s hands, and caregivers assume control only by specific delegation. This would, for example, make the idea of "visiting hours" a thing of the past.)

The sort of decision-making you're describing--in which the patient's wishes and input is conspicuously lacking--is exactly the "current state" deficiency that the IOM and the article's author are advocating against.

 

[asterism]

See how the arrogant Liberal control freak responds to valid complaints about his "ideas"? Instead of explaining himself and his moronic ideas further he falls back to that lazy old excuse of "Well, you're just too stupid to understand!"

In fairness, when someone asks if using technology to grant patients 24-hour access to medical professionals implies clairvoyance about "know[ing] when one may be in a care [sic?] accident?," declares that proposing patients define their needs is another way of suggesting bureaucrat-helmed death panels, and implies that HSA funds don't roll over from one year to the next or that tort reform isn't specifically endorsed in the article this thread is about, there actually is a chance they're simply not intellectually equipped to handle some of the concepts here.

I'd first chalk it up to partisanship and ideological blindness but it's worth exploring all the possibilities.

If seeing my mom and my child almost die in government hospitals due to government workers being inept makes me partisan then so be it.

Take your lofty studies that are nothing but bullshit and shove them up your ass. It was nothing but adherence to procedure above all that almost killed these very special people, not some commitment to actually practice medicine and accept the risks involved.

 

[asterism]

Here's the translation of that concept into a real world example:

"I think Mrs. XXXXXX is going to have a bad night"

"Well then we should sedate her now so she just sleeps through it."

----in the morning-----

"Well, it seems she had a bad night and had to be sedated so we're going to skip the physical therapy today and give her time to recover."

-------in the evening-----


"She's just not doing well. She wasn't even well enough to do physical therapy today even after we made sure she got the rest she needed."

"She doesn't need rest, she needs exercise."

"But she can't do it, see? She got sedated last night."


But I'm sure you think this is somehow better. After all, this was 2 years ago and according to these "patient-centered" studies my mom should be dead now.

I think you're missing the point, though I commend you for being the first person to approach the concepts here from a non-ideological perspective.

What you're describing is not patient-centered care. The particular principle from the article that's relevant to your example is:

(3) Current: Professionals control care. New: The patient is the source of control. Patients should be given the necessary information and the opportunity to exercise the degree of control they choose over the decisions that affect them. The health care system should be able to accommodate differences in patients’ preferences and encourage shared decision making. (I interpret this to mean that "permission" begins in the patient’s hands, and caregivers assume control only by specific delegation. This would, for example, make the idea of "visiting hours" a thing of the past.)

The sort of decision-making you're describing--in which the patient's wishes and input is conspicuously lacking--is exactly the "current state" deficiency that the IOM and the article's author are advocating against.

They are advocating against it in a way that says a panel of bureaucrats can solve the problem. Here's a hint, they can't. The problem isn't the lack of some "patient centered" program, it's the very nature of the concept that some program can solve this issue.

If a doctor is getting paid by the government then he serves that master, not ever the patient, period.

 

[Greenbeard]

They are advocating against it in a way that says a panel of bureaucrats can solve the problem.

Who is advocating that? What are you responding to?

 

[asterism]

They are advocating against it in a way that says a panel of bureaucrats can solve the problem.

Who is advocating that? What are you responding to?

You didn't read your own link?

 

[Greenbeard]

You didn't read your own link?

Which one? This is getting tedious.

 

[asterism]

You didn't read your own link?

Which one?

This one:

A User’s Manual For The IOM’s ‘Quality Chasm’ Report

This is getting tedious.

You don't know the half of it. This publication is just pablum. It basically says that the current committee isn't doing things right so we need a different committee to do things different, and have different "systems." New systems are certainly needed, but they won't work without a change in perspective and this committee just doesn't get that primarily it's the structure of this being done by committee is the real problem.

Tedious? Yup.

 

[auditor0007]

While I'm not shocked that the concept of empowering patients to take a leadership role in making care decisions is taken to mean something about bureaucracy and centralized care by the usual crew of idiots, it's still fascinating to watch. There's something impressive in that.

One of the main points here is giving patients better access to their own medical records. But more than that, it is to make those patients knowledgeable about their health so that they can actually make certain decisions when it comes to their treatment.

As it stands now, healthcare providers tend to keep patients in the dark. And sometimes, it is understandable. As much information is available on the Internet and through other sources, there are many people who over-diagnose and misdiagnose themselves all the time. However, there are many who also can adequately follow their own regimen of healthcare with much less care from healthcare providers, but it requires that the patient/person either be fairly bright to begin with, or that they be given an adequate amount of information about their health so that they can be proactive in their own care.

As an example, I have Hemochromatosis. For those of us with this disorder, we are a very knowledgeable bunch. For the most part, those that I know with this disorder, including myself, know more about the disease/disorder than our doctors do. We know how to treat it, and what is effective and what is not. Because most doctors do not have great knowledge of this condition, it has made it much easier for me personally to make most of my own decisions when it comes to my healthcare needs. And this goes well beyond just medical care. It includes what I can or should eat versus what I should not. It also includes knowing when I need to go for treatments (phlebotomies) and when not to. I also know exactly what tests I need done and when I need them which allows me to search out the least expensive places to go for these tests. And because of my knowledge of my disease and the necessary treatment involved, I am living a much healthier lifestyle that should reduce my overall medical costs.

I find it interesting that so many people here, who believe in self-reliance, will just follow whatever their doctor tells them. Doctors are a great resource, and generally they do know much more than we do when it comes to diseases and conditions that we may face. However, many of them are just as in the dark as we are, and treat their patients in a reactionary form. What this leads to in many cases, is patients who end up taking twelve to twenty pills per day, all because their doctor prescribed one pill to address something that may not even be a big problem. One pill leads to unexpected side effects, so another pill is prescribed to offset those side effects. Then more pills are needed as more side effects become common place. I have seen this kind of medicine practiced on my own parents. My mother was miserable because her doctors had her on so many medications. She finally dumped all but a couple of them and now feels 1000% better.

Don't get me wrong; I'm not suggesting that everyone should stop taking all of their medications. But it is important to understand that most doctors work in this manner. They see a symptom, and they start prescribing drugs, one on top of another. And they have the pharmaceutical companies pushing them to do this as those companies offer them free trips and who knows what to push their drugs. I don't see this as a conspiracy, but it is how things work. And many of these doctors don't get it. And since the patients have no clue, they don't get it either. They just do what the doctor says, whether it is to their benefit or detriment.

 

[Oddball]

While I'm not shocked that the concept of empowering patients to take a leadership role in making care decisions is taken to mean something about bureaucracy and centralized care by the usual crew of idiots, it's still fascinating to watch. There's something impressive in that.

Way to fall back on the old "if you can't understand the purposefully nebulous and incomprehensible, you're just too stupid" rubric of the hopelessly arrogant. Crackerjack job of living down to the stereotype of the haughty, elitist authoritarian left.

This is getting tedious.

People who spout bureaucratese like it has come down from Sinai and pretend that they're the smartest people on the planet are like that.

Maybe you'll find the crowd over at Democrat Underground more appreciative of your obviously much higher recognition of the finer points of authoritarian central control, and bands of bureaucratic nannies running the lives of the proletariat.

 

[Greenbeard]

One of the main points here is giving patients better access to their own medical records. But more than that, it is to make those patients knowledgeable about their health so that they can actually make certain decisions when it comes to their treatment.

That's a great example. There's a lot of work underway to make personal health records much more widely available. Personal health records are like electronic health records in that they make your own health information available to you electronically any time you wish but they go further, allowing the patient to integrate patient-generated information/insights right into his own record. Along with that, there are ongoing efforts to develop tools that integrate with the PHR and help people like you who are engaged in self-management of health conditions.

That kind of thing is right at the heart of what patient-centeredness means: making the patient the centerpiece of a shared decision-making process and offering them the tools and knowledge to really give them a role in directing and coordinating their own care. The current push toward electronic health records and health information exchange has huge potential for patient empowerment, which is part of the reason it's so exciting.

 

[Trajan]

I have no problem really with what you just described, however, this is something I don't want anywhere near a federal or state bureaucrat.

If a private agency totally outside gov. clutches that would require patient authorization before having to surrender this information ( which I am not on board with btw) I would say sure.