Retail Medical Clinics

[thegenius]

im just pretty big on this, personal responsibility vs govt paternalism that assumes a myopic populace. if information was made readily available about healthcare, the way it is with consumer reports and the auto industry, it might work. the early 20th century was also the time period when america laid the foundation for its ascent to the top of the world following ww2. i think enron might be a case of fraud however, and fraud is something that cannot stand. i think transparency should be important but it is a tradeoff between that and too much regulation.

law2doc ill just wage more battles when the time is ripe. history is the story of battles! there are some patients who want touchy feely then, and others who want efficiency. walmart docs can take cater to the latter. undergrad or not, neither of us are docs and can comment astutely on the real state of medicine. also its overgeneralizing to say that most ailments are incurable and thus docs are relegated to the role of patting patients on the back and hearing their woes. priests would begin to compete with docs if that were so.

This all makes sense - there is virtually no information dissemination in healthcare and that has to change. In no other market do you purchase a product or service and not know what the price is. It is all too common for patients to have procedures or take medicines without knowing what the cost is. And when you want to find out, sometimes it is virtually impossible to do so.

When my son had his surgery to correct his sagittal synostosis, my wife and I spent 1 hour on the phone with the hospital a month before the surgery to find out what it would 1) cost our insurance and 2) what it would cost us. Nobody could even give us a rough estimate.

Lastly, medicine is a results based industry, that is, physician performance and ratings are based on results (efficacy of their treatments, accurate diagnoses) and not based on their personalities. Talented doctors will always be more valuable than touchy-feely doctors (and obviously a mix of both is optimal.) I would like to read one of the studies Law2Doc cites that results is not the first thing that patients look for in a physician. Note that I'm purposely leaving out efficient doctors, because there is no relationship between efficiency and results.

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[Law2Doc]

yes priests have some involvement in medicine, but most would prefer the doc if theyre sick any day.

That's just exactly what I said - medicine has a different role. I said priests/religious leaders won't ever supplant doctors in terms of bedside care, nor should they. And that while folks in every hospital have access to them, it is their doctor that they expect to keep them comfortable, and turn to when they are dying. But there will not necessarilly be any better result in many cases. So don't expect to be able to produce great results and solely by that measure, be a great doctor, because frankly, sometimes end of life care and pain minimization are all you can provide.(And I meant CCU).

 

[Law2Doc]

I would like to read one of the studies Law2Doc cites that results is not the first thing that patients look for in a physician. Note that I'm purposely leaving out efficient doctors, because there is no relationship between efficiency and results.

I'm not sure I said "first thing" but I did suggest that things like compassion, communication, and listening skills always make the top couple of patient expectations. There are tons of resources suggesting this. I will endeavor to add more later. But for now:

See eg. http://www.ama-assn.org/amednews/site/free/prl20321.htm
http://bmj.bmjjournals.com/cgi/content/full/325/7366/668
http://bmj.bmjjournals.com/cgi/content/full/327/7415/581-c
http://fampra.oxfordjournals.org/cgi/content/abstract/cmi103v1
http://bmj.bmjjournals.com/cgi/content/full/326/7402/1310

 

[thegenius]

I'm not sure I said "first thing" but I did suggest that things like compassion, communication, and listening skills always make the top couple of patient expectations. There are tons of resources suggesting this. I will endeavor to add more later. But for now:

See eg. http://www.ama-assn.org/amednews/site/free/prl20321.htm
http://bmj.bmjjournals.com/cgi/content/full/325/7366/668
http://bmj.bmjjournals.com/cgi/content/full/327/7415/581-c
http://fampra.oxfordjournals.org/cgi/content/abstract/cmi103v1
http://bmj.bmjjournals.com/cgi/content/full/326/7402/1310

I've scanned some of these articles and they are quite interesting. I think these articles also help explain the changing med school admissions focus on candidates who are more mature, have better oral and verbal communication skills, and those who haven't just mastered the science of medicine.

I don't know if you said first thing either but from your post I got the impression that patients value communication and listening skills over technical skills. 30 years ago doctors spent/had more time with their patients so this probably wasn't as big of an issue then. Now because reimbursements are going down, doctors have to see more patients/hour to keep their salaries even, and that means less individual time per patient.

 

[CTSballer11]

I've scanned some of these articles and they are quite interesting. I think these articles also help explain the changing med school admissions focus on candidates who are more mature, have better oral and verbal communication skills, and those who haven't just mastered the science of medicine.

I don't know if you said first thing either but from your post I got the impression that patients value communication and listening skills over technical skills. 30 years ago doctors spent/had more time with their patients so this probably wasn't as big of an issue then. Now because reimbursements are going down, doctors have to see more patients/hour to keep their salaries even, and that means less individual time per patient.

Most likely when patients started gettting second opinions, asking more questions, and becoming more educated, doctors needed to enhance their people skills to keep their patients and avoid lawsuits.

 

[Law2Doc]

Most likely when patients started gettting second opinions, asking more questions, and becoming more educated, doctors needed to enhance their people skills to keep their patients and avoid lawsuits.

I think lawsuit savvy is a big part of it -- it's much harder to sue a trusted family friend and confidant than it is to sue some stranger in a white coat. But there have certainly been plenty of non-law-related pushes toward patient autonomy, patient bills of rights, etc. which empower patients to play more of a role in the process, and let doctors know their wants and needs.