Treating Disease Is No Substitute for Caring for the Ill

[Lawpy]

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A good essay from Wall Street Journal:

Treating Disease Is No Substitute for Caring for the Ill

America’s health-care system focuses on curing acute problems but does far too little to support patients with chronic maladies.

www.wsj.com

EDITED by mod staff: Please don't post copywritten materials without permission of the publishers if it's not freely available (WSJ is behind a paywall).

 

[deleted480308]

No one wants to pay for these long heart-to-heart talks the author wanted. FM docs are pushed into 15min time slots by insurance/medicare. And sending a 24hr home health worker to your house is expensive. Patient families are the ultimate responsibility for paying for the care, get good insurance or save up for your loved ones.

Also, remove the locks on interior rooms if you have a serious dementia patient in your home

 

[alprazoslam]

academic ivory tower mules proposing things that don’t work in the real world.
Next

 

[seeinghowitgoes]

Exactly as @sb247 alluded to - reimburse it and the doctors will follow. Keep making needlessly detailed documentation on 25-35 patients a day necessary for getting paid and docs will look at the computer during the visit.

Also I think that Kleinman, whose writing I do generally like, does what many other “medical humanism” (for lack of a better phrase) writers do (Varghese also comes to mind). They assume somehow that the medical establishment’s role should be to provide this other type of care, that doctors are best suited to accompany the sick and their families through all stages of illness, and that the need for this specific kind of care by the medical establishment itself (as opposed to other actors) is somehow a fundamental one, not just a culturally informed one.

In many places, family provides the caring and the medical establishment provides medical care. That doesn’t mean you can’t or shouldn’t be an empathetic, compassionate physician who cares deeply but to think that on a 20 minute visit you can both diagnose and treat complex diseases and their sequelae and also be a therapist for both the patient and the family of a patient is absolutely absurd. At some point, it’s ok to admit not every type of problem is best solved by the doctor - there may need to be a culture shift in the US where people adjust their expectations of the medical establishment and begin to further utilize therapists, support groups, family/friends, etc. in many places that is already the norm, and in my opinion it is far from a universal human need that the doctor specifically provide all these services.