"Obviously, physicians are not taught the
same things in every medical school. Add to
that an enormous arena of experience and treatment
bias, which varies with each physician teacher and
instructor. It is a very effective additional
means of learning from other
physician's experiences."
A hundred years ago that question never came up, and for good reasons. Physicians were the boss and patients were just glad that there were some around to treat them, without ever a thought about challenging their doctor, his knowledge, or his advice.
We all see today how much that has changed. However, there have been add-ons to the healthcare issues and debate about what is right or wrong for medical treatment. At first, we got the best medical training we could and practiced with the skills and medical knowledge we had--even though we all continued to expand on both throughout our careers.
Then we were criticized by politicians and others for not providing the best care possible. The medical hierarchy was intimidated by that, so CME (continued medical education) was mandated, which most of us were already doing appropriately--it's just part of our continuing to learn mindset as physicians.
In the 1970s' the costs of medical care were rising, big surprise I guess, and large corporations and unions essentially forced the government to start dictating to physicians what they envisioned as best healthcare. They added Managed Care into the already complex healthcare formula thinking they could provide "best" care at a cheaper cost--and failed.
Medical care then became addicted to the concept of evidence based medicine, which had been an integrated part of healthcare years prior--interesting that outsiders never noticed that earlier.
Along came a new set of pro-government health experts who were joined by complicit medical doctors who developed the "quality of care" dogma, which resulted in "best practices" criteria. At this point health care costs were continuing to rise (never had stopped rising or even leveled off), but now the experts were involved with, and supported by, a very lucrative medical industry of "controls." Physicians now are going to get report cards and graded on criteria derived by quasi-medical experts to be quality of care.
Throw a wrench into the the system, then what?
There are a pile of wrenches that continue to stagger the brilliant minds of social
and governmental economic healthcare experts outside of medicine such as...
1. The quality criteria about best practices is assumed to be the best, so compliance
is the only option.
2. The basic criteria is guesswork because patients do not respond to the same treatment
or medication for the same disease or health problem exactly the same way.
3. The latest news reports that research based medical evidence may in many cases be in error,
and the physicians have been fed wrong medical data to treat patients with.
4. The wrong medical evidence and studies came about because the results came off a pile
of statistics, computer material analysis, and little attention to patient testing and results
where real results are proven.
5. Throw in the fact that a large part of medicine today is a consequence of dictation by
patients themselves. Some do what the medical doctor advises, some don't. Why should
anyone trust a doctor today? So, if patients control their own care, then all medical treatment
results are inaccurate and the research data is skewed. Likely, most patient data results
will remain subjective in any study.
6. Now, the non-medical experts, governmental, political-economic think tanks, and even those
physicians in high places who think in terms of insuring quality of care for everyone believe
it can be done--yet they all continue to spit into the wind.
7. Medical care will never be available to everyone no matter what is tried and forced on the
population. This can only mean that government is doing all this to create more control of
people and power, all the while forgetting that medicine isn't a predictable, scientific
step-by-step criteria that fits everyone.
8. Physicians will never be open to do their best care when such things as fee controls, lack of
medical malpractice verdict caps, extreme costs and debt of medical education that cripple
any graduating physician's chance of paying off the debts and start private practice, and
the continued disintegration of medical doctors status as a professional are present--way
too many rules to live by that make good decisions almost impossible.
Comment:
I suggest you read a WSJ article March 31, 2012-C3 by Pamela Hartzband and Jerome Groopman, titled, "Rise fo the Medical Expertocracy" for further illumination on this topic. It's going to be a wild ride for new medical students facing the future of medicine.
My ultimate question remains about the future of medicine, what would happen if all pre-med students were told everything about the problems in medical practice today? Would it make any difference to them or their choices? Or would they continue to follow their dream no matter the consequences might be?
The standards for best treatments varies. The standard for the criteria for quality of healthcare and medical treatment varies. Medicine and quality of care are dependent on the variable criteria, on changing medical treatment , understanding, and knowledge, and on the extent of medical research findings at the time. In many cases the best results is a matter of statistical data.
So, when we live in a world and profession that is undergoing constant changes, no one can expect total understanding or perfect knowledge. However, as experience increases in the world today, it seems to be at least one means of moving the scale closer to perfect medical practice understanding and knowledge.
----Professional Probe----
"Changing the road we are traveling on in the medical profession seems to be a lot easier than one may think. By changing only one aspect of the process at a time is the most productive means of initiating changes and it enables the foundational structure to remain functional and efficient.
This is the means for adding a business education curriculum to the medical educational platform efficiently, and if attention is focused on the monumental advancement of the medical profession, the astounding improvement in
healthcare and medical treatment, and the impressive increase in the
potential of every medical doctor that will happen overnight."
Articles©2013-2022/CGG INVESTMENTS LLC. All rights reserved. #144, 3-16-22
