|HEALTH CARE CRISIS IN USA.....SOLUTION: DOCTOR-PATIENT PARTERNING COMMITMENT IN KEEPING WELL & GETTING CURED ..... |
Posted by Vishva News Reporter on August 17, 2009
DEAN BICKNELL, CALGARY HERALD, CANWEST NEWS SERVICE, FILE
predict a visit to the doctor’s office
will become more like a dinner conversation
and less like being called to the principal’s office...
Says Dr. Ted Epperly,
President of the American Academy of Family Physicians and
a family doctor in Boise, Idaho
- The culture of health care already is beginning to
with two ideas gaining the most traction;
One is shared decision-making,
where patients receive unbiased “decision
hash out with their primary-care physicians
the risks and
benefits of various screening or
treatment options before proceeding;
- The other is evidence-based medicine,
where doctors choose remedies
what’s proven to work in peer-reviewed studies.
Marge Ginsburg, Executive director of the Center for Healthcare Decisions,
a non-profit group in Sacramento, California:
- But some physicians may need to learn new communication
to refocus the conversation when patients demand
tests or treatments that are inappropriate for them;
- A lot of it is how you word it,
developing an action plan that patients
- Likewise, patients need to stay vigilant and question
a doctor if the recommended course of action
seems too hasty,
invasive or extreme.
|TO MAKE TOMORROW HAPPIER THAN
TODAY ....with Knowledge-based lifestyle requires YOU to
take charge of your life and live by the rules and regulations of
sciences of DHARm and aayuARvED-vED-vED which operates and sustains life
as per the Creator's life design.....
This means that YOU need to know, understand and do what your doctor
says to cure YOURSELF when YOU get sick....But the important thing is
not to live a lifestyle which makes you sick in the first place.....PVAF
has published many vED sciences articles in this regard on this web
Today PVAF publishes the current take on YOU and YOUR DOCTOR... to stay
healthy and also have an affordable health care system with your doctor
when YOU do get sick....Please click on the next line to read the USA
report on the doctor-patient partnering which has been summarized above.....
as health costs rise....
care focus will be on
weeding out wasteful spending,
honesty in explaining
options, shared decision-making....
Journal: 7 Aug 2009: Kristen Gerencher, McClatchy Newspapers,
Your visits to the doctor are likely to take on a different tone as
efforts to stem rapidly rising health-care costs move forward,
transforming what often feels like a trip to the principal’s office into
something more like an intimate dinner conversation.
Much of that conversation will be about not just what treatments and
drugs you need, but how much they cost, what they might do for you and
whether, in the end, your health will really benefit.
It will involve getting back to basics where patients and primary-care
doctors establish trusting relationships that last beyond one or two
visits, says Dr. Ted Epperly, president of the American Academy of
Family Physicians and a family doctor in Boise, Idaho.
“By having the relationship I can help you avoid having these things you
don’t need,” he says. “More care in our health-care system is not
necessarily better care.”
That doesn’t mean patients won’t receive life-saving treatments or
cutting-edge technologies to improve their health when such things are
warranted. Instead, the focus will be on weeding out wasteful spending
in more routine cases where less is at stake.
If there’s a history of mutual honesty and transparency, it’s easier to
dissuade patients from receiving an expensive drug they have seen
advertised on TV or from doing costly imaging or lab work that won’t
improve their health, Epperly says.
Doctors should be forthcoming about discussing the alternatives,
especially when a patient is facing a life-changing diagnosis, he says.
“The patient should expect that the physician will share all the options
with them — from everything being done to nothing being done.”
In exchange, patients should signal that they don’t necessarily want to
act on all the possibilities, Epperly says. Such verbal reassurance lets
doctors avoid the costly, sometimes harmful, practice of defensive
medicine that aims to protect them from lawsuits.
“That will help the physician not to default to the natural position of
overordering things because it’s easier to do things to people than not
do things to people, especially if you’re getting paid to do it.”
Overuse of procedures and certain imaging tests actually can lead to
poorer health results by needlessly subjecting patients to possible
medical errors, hospital-acquired infections or, in the case of
increasingly popular CT scans, exposure to a higher lifetime risk of
cancer from cumulative radiation.
The culture of health care already is beginning to shift, with two ideas
gaining the most traction.
One is shared decision-making, where patients receive unbiased “decision
aids” and hash out with their primary-care physicians the risks and
benefits of various screening or treatment options before proceeding.
The other is evidence-based medicine, where doctors choose remedies
based on what’s proven to work in peer-reviewed studies.
In some cases, patients won’t notice a difference in their care because
doctors effectively explain the reasons for pursuing a less aggressive
approach, such as forgoing an MRI scan for low-back pain unless symptoms
change dramatically or no improvement is shown over a period of time,
says Marge Ginsburg, executive director of the Center for Healthcare
Decisions, a non-profit group in Sacramento, Calif.
But some physicians may need to learn new communication skills to
refocus the conversation when patients demand pricey drugs, tests or
treatments that are inappropriate for them, she says.
“A lot of it is how you word it, developing an action plan that patients
Likewise, patients need to stay vigilant and question a doctor if the
recommended course of action seems too hasty, invasive or extreme.
“It’s not easy to convince people of the likelihood that their doctor
may be ordering things that may not have a scientific basis,” Ginsburg
That’s where patients can benefit from decision aids, comprehensive
summaries of the evidence about common medical choices that are free
from industry influence, says Lyn Paget, director of communication and
outreach for the Foundation for Informed Medical Decision Making in
“Every patient should really have access to a complete, balanced
decision aid to allow them to be well-informed when they make the
decision and have a high-level dialogue with their clinicians,” she
says. The foundation works with medical groups to integrate these into
Shared decisions often result in higher patient satisfaction, regardless
of the outcome.
“Most patients, when they are wellinformed, choose very conservatively,”
Paget says. “The data has been showing that for quite some time.”
Patients increasingly are taking a more active role, says Dr. Diane
Rittenhouse, associate professor of family and community medicine at the
University of California-San Francisco.
“They’ve gotten a lot of information out in the world and are trying to
make sense of it, and the doctor says, ‘Here’s a choice you have, but
let’s make that decision together based on ... what your preferences
are, where you are in your life and what side-effects’ ” can be
expected, Rittenhouse says.
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