Monday, October 14, 2013


What does that mean? Everywhere I look, the same words taunt me as if the very essence of medicine has been non-patient centric. As if the world has been operating on the mean, self-centered, narcissistic reward-finding jollies. Oh and we forget that it was patient-centricism that helped raise the cancer survival rate over 56%, create the biomechanical limbs, parts of the eye, ears, nose, a heart, a hand, a kidney or a lung, transplanted or through sheer brilliance created from stem cells riding up the scaffolding, curing tuberculosis, vaccinating Polio out of existence, extending life in the most dire circumstances of a diseased imperil, or helping replace diminishing hormones of a diseased organ, or keeping the heart ticking when the sludge of excess clogs the supply arteries to it, or keeping the lungs breathing when the sacs are rigid and have lost all expansion, or survive and thrive after the many other human ailments that result from the wrath of the whips and scorns of time. And this they claim was done for the ulterior motive of self-service?

And yet every dialog now begins with the same two hyphenated words; “patient-centric.” Those that regurgitate these words, mumble to themselves, for deep inside they realize in these politically correct times, not repeating the mantra is akin to a target for blame, vilification and demonizing. The articles written by "experts" all suggest that diagnostic and therapeutic decisions should be done with the patients. Up until now, do they really think that it has not been that way? Every test requested is recommended for a purpose of patient care and every treatment offered is determined based on the best potential outcome with the patient's knowledge and consent. Is that not "Patient-Centric?"

Lets face it if you just look at the Lung Cancer survival rates for Stage IV disease, the Europeans (the countries we want to emulate for cost measures) have it at 7-8% while in the US the data shows 14-15%, Is that not patient centered decision making. If the patient wants to fight the disease and the odds, ours is a purpose of defining the fight and the potential of success and failure. If we as physicians don't do that, then we fail our patients and the legal system is ready with its whips and scorns to pounce on us. If all Stage IV Lung Cancer patients were sent to hospice immediately then the survival rate would be ?%? There is a new definition of medical care being implanted in the minds of newly graduated physicians and patients. The media blasts the use of medical care for the very old and infirm and suggests that we are robbing the future of the youth. But under the same breath these very people are mortgaging our and our progeny's future with printed money and a $17 Trillion debt that bears a $1 Trillion interest payment every year.It appears as a pick and choose policy. True the Healthcare expenditure is 15.6% of the GDP and it has to be reigned in. But there are easier, simpler models that can do that. If we can only get these experts that are super-specialized in minor nuance of the economy and cannot see the forest for the trees, out of the way. Unless there is "skin in the game" from all the stakeholders, costs will run rampant. That is the very nature of the beast that feeds on the dilution of facts to enrich its own core. We as a nation of innovators and entrepreneurs have come to espouse new and wonderful discoveries and that comes at a steep cost. The US with its expensive care, which by the way is mostly accounted for by the hospital expenses, the pharmaceutical companies and Device manufacturers, lives on the edge of discovery. The latter two are responsible for the success against diseases like HIV/AIDS across the globe, diabetes management, cancer biologic and targeted therapies and the list continues to proliferate. All this comes at a cost. We can stop all tthat and live with what we have, too. But are we prepared for that? Even if we are, shutting down the engine of Research and Development hurts the future in incalculable ways. And thus, we  cannot have it both ways.

But before we scoff it off, Menafn has a warning...

...according to the National Health Council based in Washington, DC,incurable and ongoing, chronic disease affects approximately 133 million Americans, representing 45% of the total population. By 2020,that number is projected to grow to an estimated 157 million, with 81 million having multiple conditions.

More than 75% of all health care costs are due to chronic conditions according to the United States Center for Disease Control (CDC). Four of the five most expensive health conditions (based on total healthcare spending in a given year in the United States) are chronic conditions -- heart disease, cancer, mental disorders, and pulmonary conditions."

  Are we ready for that? Maybe we should foster "Personal Responsibility" for our health, rather than a dependency, to limit this scourge of "chronic disease epidemic." That national recognition will depreciate the cost of care dramatically in less then a decade.

Front page covers, large glossy ads and even cheap shots at health care litter the field. But I digress. And man can I...

Meanwhile in the storm of this new form of medicine that rages, the only real ill wind that blows, I see, comes from the rising gale of denials of service by the zombies, of denials of diagnostics, of denials of therapy, of everything but what they claim modern medicine is!

 Oh woe!

And that IS Patient-Centric?

“See what a scourge is laid upon your fate that heaven finds means to kill your joys with love…”

A strange kind of love this is, …full of sound and fury…signifying NOTHING!”

Somethings just need to be said.

Let the rotten eggs and tomatoes rain.

1 comment:

  1. Obamacare Has Been Good For United Healthcare.