Another Reader Letter to Immortal Bird Author Doron Weber on Patients and Doctors. Plus The New York Times on Why Doctors are not Rated on the Web
I recently received this letter from a reader:
Your work to tell Damon’s story, with straight talk about the medical system’s role in the end of his life, helps a lot of us out here, who have similar misgivings. I am reminded of the straight talk we get from Jerome Groopman, Abraham Verghese, and Atul Gawande. We need more of it. I am especially interested in the failures that appear to me to rise from structural causes in medical systems, things that the medical industry (schooling, residency, practice) can make right, if they will. To be sure, I am extremely grateful that some good people want to become doctors; but the systems in which they place themselves contain weaknesses we can still improve by observing carefully, studying and explaining.
In healthcare systems it is increasingly important, I believe, to re-institute the patient’s own views as a key factor in every aspect of care, no matter how young, how sick, how afraid or disturbed, how angry or sad. After all, if people are sick they ought to be afraid, disturbed, angry or sad. Their families too. Any medical system that systematically separates the patient from the physician who make decisions about the patient, even small kinds of separation, is not going down the path of successful healing.
Where the critical patient is knowledgeable and has keen insight into humanity (ridden with “the persistence of chance and its amorality”), the weakness of medical systems and of their acolytic high-earner physicans are exposed. They are exposed through two things:
1. an indomitable effort of the critical patient to discover through the systems and the competing protocols, paths that seem to work for him
2. powerful pressures of reputation and earning power that cause physicans to overlook each patient’s uniquenes, and to commit to the given case less humanity than the patient deserves.”
In addition to this thoughtful letter, today’s New York Times had an interesting article by Ron Lieber “The Web is Awash in Reviews, but Not for Doctors. Here’s Why.” Lieber writes that while reviews and ratings of restaurants and hotels have changed those industries for the better, “it is puzzling that there is no such authoritative collection of reviews for physicians, the highest-stakes choice of service provider that most people make.” He provides an insightful and tough-minded analysis of various factors behind this omission including legal threats and intimidation by the medical profession, patients’ fear of being blackballed if they give their physician or hospital a negative rating–especially in smaller communities where there may not be many medical choices–and a passive, unquestioning mind-set. And he points out that even where reviews exist, they are incomplete because they lack the all-critical outcome data. It’s worth reading the article in full.