Hello and welcome. I am Dr. George Lundberg, and this is At Large at Medscape.
Who is in charge: the physician or the patient? Who knows best? Does patient autonomy trump physician autonomy? Should the "inmates be running the asylum"?
Is there still such a thing as "doctor's orders"? Is the patient a "client," a "consumer," or a "customer?" Is the customer always right? Is satisfaction guaranteed or your money back?
Should patients take charge of their health? After all, it is their health.
Who is the consumer of healthcare? Is it the government, the insurance company, the family, or the patient? Does it all depend on who pays the bill?
Patient-satisfaction surveys are currently considered the be-all, do-all, and end-all of American medical care and are driving many physicians nuts. In order to garner good scores and thereby be paid more -- or even keep their jobs -- must physicians take unnecessary throat cultures, obtain PSA (prostate-specific antigen) levels in asymptomatic men, prescribe azithromycin for viral upper respiratory infections, order MRIs for low back pain, mammograms for young women, CT scans for headache, opioids for arthritis pain, or whatever?
All the while, some for-profit company from South Bend, Indiana, rakes in the profits by tormenting modern American doctors with its special leading brand of patient-satisfaction assessments. Is an individual patient's satisfaction at survey time really more important than considerations of physician knowledge and judgment, public health, and the health of the economy?
I think not!
Where are our American Medical Association and the rest of disorganized medicine? Has the physician no rights and no responsibilities, except to assure a happy, if ill-informed and poorly treated, patient?
As a father of five and grandfather of eight, I blame the entire mess on Dr. Spock's damn permissive childrearing. I blame him, plus all of those MBAs who are running and ruining American healthcare.
That is my opinion. I am Dr. George Lundberg, at Large for Medscape.
Medscape Internal Medicine © 2014 WebMD, LLC
Cite this: Who Knows Best? Not Benjamin Spock! - Medscape - May 30, 2014.
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