by CathyG | Aug 31, 2014 | medical care
Today’s Wall Street Journal had yet another story by a disillusioned doctor: Why doctors are sick of their profession
Jauhar actually offers a balanced view. He points out that doctors were warned they would kill the goose that laid the golden eggs; many doctors still perform unnecessary surgery. I am healthy and rarely see doctors, yet when I had a small ovarian cyst, a doctor tried to persuade me to undergo a complete hysterectomy! I switched doctors and had an outpatient procedure in just a few hours.
The irony is that managed care often doesn’t prevent unnecessary or wasteful treatment. The term “preventive care” should be replaced with “risk reduction medicine.” Much of a primary care doctor’s work involves screenings of perfectly healthy, asymptomatic people that cannot be justified by research findings.
Doctors are still trained to memorize molecular structures but they need courses in statistics and decision making. Recently the WSJ published a review by a cardiologist who insisted that deaths from heart disease were down by 60%. I looked up the numbers: the reduction was 172/100,000 and that doesn’t account for things like errors in coding causes of death.
And while doctors complain bitterly about lack of respect, many of them persist in making elderly patients (and those close to end of life) suffer with unnecessary treatment. Just read any list of comments in a NYT article. I’ve heard first-hand accounts of 90-year-olds given colonoscopies, paid by Medicare; a doctor writes about aging Alzheimer’s patients getting painful needle tests for diabetes, ordered by a doctor, who can’t be stopped. yet few insurance companies give them what they need – massage, good food and privacy. I’ve heard even more horror stories of doctors who disregard DNR orders and who think they’re doing a service by keeping someone alive for a meaningless, drugged-up existence in a nursing home.
Finally, doctors have limited accountability. It is very, very hard to sue a doctor. Doctors make claims on their websites (and in practice) without disclaimers and disclosures of conflict of interest. Eye doctors actually place ads in their office magazines (“Want great vision? Talk to us about …”) without warning that these procedures do not always turn out well and sometimes make vision worse.
by CathyG | Aug 12, 2014 | health care waste
The New York Times article (Unkind Life For Young and Old, Aug 7) highlights yet another way the US wastes money. It costs $100,000 a year to maintain an aging prisoner, and prisons aren’t exactly geared for “aging in place.” They have unsafe stairwells, a ban on canes and of course no geriatricians on staff.
Geriatric prisoners rarely pose a threat to society so there’s little reason to keep them.
Jamie Fellner, author of a Human Rights Watch, was quoted in another article as saying, “Age should not be a get-out-of-jail-free card.” But why not? In some countries, people over 70 do not go to prison, period. I doubt that we’d see many people over 70 suddenly going on crime sprees; the rare cases of white collar crime, like Madoff, could be handled with supervised probation or fines.
by CathyG | Aug 6, 2014 | health care waste
The New York Times :Why We Should Know The Price Of Medical Tests. http://nyti.ms/1ooBGQP
My comment:
Oh come on … the outrageous amount we spend on health care isn’t driven by saving a few bucks here and there on price-shopping.
Just for starters, Medicare pays $300 million a year for pre-op tests for outpatient cataract surgery, when research shows these tests have no impact on outcomes. Then there are billions spend on “end of life” care because doctors and hospitals disregard DNR and DNI, even when the correct forms are in the charts.
And the billions spent on “preventive care” that doesn’t prevent anything; at most you get risk reduction, usually a small amount.
And the inflated hospital charges ($147 for a Tylenol, $500 for a bag of salt water). I’d be willing to bet that 30-50% of these “medical tests” are not even necessary.
So now they want sick people to shop around to save a few bucks? And a hospital can say, legally, that prices are secret so you can’t even if you want to?
No wonder we’re not hearing much about the Mafia. They’re probably running the medical industrial complex.
by CathyG | Jul 15, 2014 | dying with dignity
In this article, Addressing Capacity, Dr. Mark Lachs notes that 40-50% of people over 85% have some form of cognitive impairment.
In one example, a woman refuses to admit caretakers to her home. “What if there’s a fire?” she’s asked.
If she says, “I’m willing to take the risk,” she may just not be aware of what’s going on.
If she says, “I’ve lived a long life and I am willing to take that chance to maintain my privacy and independence. I can wear a life alert pendant.”
Dr. Lachs notes that people have the right to make that choice. I wish more doctors did.
by CathyG | Jun 21, 2014 | stereotypes of aging
(1) Your own personal cyanide pill. At this point, modern medicine can only do so much for you. If you want to check out, you should be able to do so, on your own terms, without explaining to anyone.
If you’re worried about upsetting your family, you should get access to a hitman from your local Mafia enclave. They’ll make it quick, clean and painless. Your family will be told, “An unfortunate accident and she had no pain at the end.”
(2) The right to use 4-letter words, including the F-word, any time, especially when you’re talking to a doctor, an insurance company, or some broker who cold-called you to transfer your IRA to his company. You’d be surprised how much gets done after you call somebody a mother-fucking idiot.
(3) The ability to make a citizen’s arrest of anyone who calls you “honey” or “dear,” especially in a professional setting. If they grew up in South Philly, they can plead mitigating circumstances.
(4) The right to knock somebody on their ass if they grab your arm without permission, thinking they’re being kind and helpful, when in fact they’re being patronizing and controlling.
Alternatively, you can hand them your big heavy backpack and say, “Oh, that’s so nice, dear – how about carrying this for me?” all the way to the door of your gym.
(5) The right to opt-out forever from all age-related mailing lists, especially those invitations from AARP and those newsletters from health care agencies, hearing aid companies and hospitals.
