From the point view of patient's, an important focus of healthcare reform is to directly
interact with their healthcare decisions. While this is a laudable goal, there are a number
barriers need to be cleared in order to make it viable. Why most patients are not good
partners when it comes to healthcare decisions for themselves or loved ones? I believe there
are at least five reasons:
Distress
Patients come to a physician typically only after a disease or process has progressed to the
Patients come to a physician typically only after a disease or process has progressed to the
point that it is no longer comfortable for them to ignore it. This distress, by itself, puts
the patient at a disadvantage for making judgments and assessing importance.
Denial
When faced with any significant issue, particularly one affecting health, most patients move
When faced with any significant issue, particularly one affecting health, most patients move
relatively quickly through the phases of grief, from shock to denial. Feelings like, “it's
not that bad,” or, “that doctor doesn't know what he's talking about,” are common. Denying
the disease itself or the cause of the disease frequently leads to treating symptoms and not
the illness.
Dollar
When presented with different options for therapy or diagnosis, cost is frequently never
When presented with different options for therapy or diagnosis, cost is frequently never
discussed. When it is, the more subjective idea of the "value" of each alternative is more
difficult to convey. This is because physicians and other providers have spent years in
school trying to get a handle on just that question.
Data
Patients, armed with the latest Google search present themselves to their provider with a
Patients, armed with the latest Google search present themselves to their provider with a
complaint list and everything they "know" about their illness. Physicians can have difficulty
sorting through what is true or reasonably true versus the latest ad, wrapped up as real
information.
Dose
From the radiology standpoint, patients are being told that their diagnostic examination will
From the radiology standpoint, patients are being told that their diagnostic examination will
lead to cancer — at least that's what many remember from the latest media blast. In ALARA
terms, sometimes the highest dosage radiology examination( taken by a mobile x ray machine, c
arm, digital x ray machine, etc), is the one has the biggest value. The exam with the least
value and lowest cost offen has the lowest dose and sometimes it's a mixture of highest cost
— lowest value or lowest cost moderate value.
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