What would you change and how?

[hippocrateze]

This question is for those of us who, though committed to our particular field/specialty, have misgivings about particular aspects: be it lifestyle, pay, liability etc.

What one thing about your profession most disturbs you, how would you change if you could and how?

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[docB]

The current medical malpractice climate is horrible. If we could get real, far reaching reform I'd work for a lot less.

 

[Shredder]

Ppl nagging about abortions. Leave it up to states to decide.

 

[akinf]

The capitalist system, the class system, race conciousness, class conciousness, modern day slavery, poverty (here and afar), post-colonial effects on developing nations, the way research conducted and disseminated to the public, the amount business could make, the amount people could, the education system, the family, the military, the police, the economic elite, the military elite, the bureacratic elite, lobby groups, social conciousness, global awareness, teen pregnancy, HIV/AIDS infection rates, infectious diseases, racism, sexism, homophobia, the Catholic Church, the Anglican Church, Liberation Theologists, the Africa, Eastern Europe, Russia, Asia, Latin and South America, the environment, global warming, pollution, greenhouse gases, alternative fuel, water cleanliness in developing countries, sustainable development in the area of agriculture and infrastructure in developing countries...and many more things


I know this is only ONE thing about your profession, but there are too many things ignored everyday for them not to be mentioned.

My $0.02

 

[Shredder]

The capitalist system

post-colonial effects on developing nations

Such as Singapore, Hong Kong, Australia, the USA, South Africa, northern Africa--all of the most liveable parts of the world (relative to the rest of Africa, for the latter two)?

Did you score 1400+ on the SAT?

 

[akinf]

Such as Singapore, Hong Kong, Australia, the USA, South Africa, northern Africa--all of the most liveable parts of the world (relative to the rest of Africa, for the latter two)?

Did you score 1400+ on the SAT?

Umm, no, I didn't even take the SAT. Let's not forget India.

 

[hippocrateze]

Umm, no, I didn't even take the SAT. Let's not forget India.

Not that all these other points are not very relevant, but for the purposes of this discussion could we stay within the realm of medicine? Also, please suggest specific measures you think could change the things that bother you.

 

[EctopicFetus]

Defensive medicine. Why does a sprained ankle cost more (X-rays etc.) than giving birth to a health child?

The whole lets just order this or that, well some of those tests have no utility but cost hundreds of dollars.

 

[EctopicFetus]

Umm, no, I didn't even take the SAT. Let's not forget India.

No comment.. your post is like a Billy joel song but not as interesting.

 

[McDoctor]

I would remove all of the advertising by pharmaceutical companies and would like to see a change in the way that the patient has become a consumer of healthcare. Most office visits that are borne out of a patients request to try a medication that he/she saw on TV tend to suck the life out of me. This is the same mindset that leads every patient who has a headache or depression/anxiety to demand an MRI of the brain. These commercials have a negative impact on the doctor/patient relationship because they cause patients to see us more as healthcare merchants rather than educators and doctors.

 

[docB]

I would remove all of the advertising by pharmaceutical companies and would like to see a change in the way that the patient has become a consumer of healthcare. Most office visits that are borne out of a patients request to try a medication that he/she saw on TV tend to suck the life out of me. This is the same mindset that leads every patient who has a headache or depression/anxiety to demand an MRI of the brain. These commercials have a negative impact on the doctor/patient relationship because they cause patients to see us more as healthcare merchants rather than educators and doctors.

I agree with the jist of your post and I definitely agree about everyone demanding silly stuff. Is the part about "most" office visits being due to TV ads true? Do you have a source on that? If you don't and were just making a point that's cool, I'm just curious.

 

[akinf]

Not that all these other points are not very relevant, but for the purposes of this discussion could we stay within the realm of medicine? Also, please suggest specific measures you think could change the things that bother you.

Everything I've mentioned can be traced back to the Industrial Revolution and the market economies that have been generated from it. Essentially, industrial nations need to change the way business is done with other nations with less economic prowess. Sure, money is typically the focus, but it is important for that mentality to be complimented by thought for the well-being of other nations. Now, that is a difficult task to accomplish to say the least, but it starts by freeing nations of current massive debt (not necessarily all debt, but a sufficient percentage) so that they are not forced into trade "partnerships" that benefit one immensly, and the other slightly.

Suppose all countries did what China did in the early days of its economic boom. Open up countries to massive foreign investment at a good return to investors. This would promote exploration of under-utilized and undeserved markets. It would create a global community that allowed for the further understanding of countries the world over.

Bottom line, a way is needed to ensure countries that are suffering get an infusion of resources to become sustainable primarily on their own. A massive expansion of basic agricultural practices, engineering technologies, medical care, advanced education, and basic infracture to help developing nations get onto the path to significantly improve their quality of life.

To do this, cooperation from the international community is required, and I am not talking about the UN. What the UN does is good, but ineffective because they are so heavily funded by few nations that carry major weight in decisions of the UN's future. Countries need to meet independently to take action and address the serious problems facing these countries.

I believe the underlying issue of all concerns is poverty, however, poverty stems from unequal access to resources. So those with access to resources either need to share, but since it appears like these countries are unwilling to share without something in return, it is the developing nation and industrialized nations responsibilities to find a way for the developing nation to obtain its own resources and make them last.

 

[akinf]

No comment.. your post is like a Billy joel song but not as interesting.

Not really sure what that's supposed to mean.

 

[hippocrateze]

Everything I've mentioned can be traced back to the Industrial Revolution and the market economies that have been generated from it. Essentially, industrial nations need to change the way business is done with other nations with less economic prowess. Sure, money is typically the focus, but it is important for that mentality to be complimented by thought for the well-being of other nations. Now, that is a difficult task to accomplish to say the least, but it starts by freeing nations of current massive debt (not necessarily all debt, but a sufficient percentage) so that they are not forced into trade "partnerships" that benefit one immensly, and the other slightly.

Suppose all countries did what China did in the early days of its economic boom. Open up countries to massive foreign investment at a good return to investors. This would promote exploration of under-utilized and undeserved markets. It would create a global community that allowed for the further understanding of countries the world over.

Bottom line, a way is needed to ensure countries that are suffering get an infusion of resources to become sustainable primarily on their own. A massive expansion of basic agricultural practices, engineering technologies, medical care, advanced education, and basic infracture to help developing nations get onto the path to significantly improve their quality of life.

To do this, cooperation from the international community is required, and I am not talking about the UN. What the UN does is good, but ineffective because they are so heavily funded by few nations that carry major weight in decisions of the UN's future. Countries need to meet independently to take action and address the serious problems facing these countries.

I believe the underlying issue of all concerns is poverty, however, poverty stems from unequal access to resources. So those with access to resources either need to share, but since it appears like these countries are unwilling to share without something in return, it is the developing nation and industrialized nations responsibilities to find a way for the developing nation to obtain its own resources and make them last.

Thank you for the economic/socio-political discourse. However, the whole reason for starting this thread was to see what we as doctors can suggest to change the things that bother us, rather than moaning about them.

Who knows, maybe we can actually come up with workable solutions (even little ones count) that can be implemented without waiting for 'the powers that be' to catch up.

Why do you insist on changing the tone and topic of the discussion? All valid thoughts, but would you mind starting your own thread?

 

[akinf]

Thank you for the economic/socio-political discourse. However, the whole reason for starting this thread was to see what we as doctors can suggest to change the things that bother us, rather than moaning about them.

Who knows, maybe we can actually come up with workable solutions (even little ones count) that can be implemented without waiting for 'the powers that be' to catch up.

Why do you insist on changing the tone and topic of the discussion? All valid thoughts, but would you mind starting your own thread?

Fair enough.

 

[McDoctor]

I agree with the jist of your post and I definitely agree about everyone demanding silly stuff. Is the part about "most" office visits being due to TV ads true? Do you have a source on that? If you don't and were just making a point that's cool, I'm just curious.

No I didn't mean to say that most visits by patients are regarding something they saw on TV. For the most part, most patients come in with symptoms and want the opinion of a doctor. What I meant was that most of the time, when these visits regarding a request for a medication seen on TV occur, they tend to be frustrating and unproductive.

For instance, this medication Requip that is constantly being advertised for Restless Leg Syndrome is in fact a potent medication originally designed to treat Parkinson's Disease. I would be hesitant to prescribe it except in severe cases of Restless Leg Syndrome where the diagnosis is confirmed via a sleep study. There are no long term studies to suggest that this medication is safe for long term use in otherwise healthy people. However the commercial is very persuasive in making people think they need this potent CNS dopamine agonist for common sensations of leg discomfort which may or may not represent a disease state.

 

[hippocrateze]

No I didn't mean to say that most visits by patients are regarding something they saw on TV. For the most part, most patients come in with symptoms and want the opinion of a doctor. What I meant was that most of the time, when these visits regarding a request for a medication seen on TV occur, they tend to be frustrating and unproductive.

For instance, this medication Requip that is constantly being advertised for Restless Leg Syndrome is in fact a potent medication originally designed to treat Parkinson's Disease. I would be hesitant to prescribe it except in severe cases of Restless Leg Syndrome where the diagnosis is confirmed via a sleep study. There are no long term studies to suggest that this medication is safe for long term use in otherwise healthy people. However the commercial is very persuasive in making people think they need this potent CNS dopamine agonist for common sensations of leg discomfort which may or may not represent a disease state.

I agree with you there; what people need is real education about new drugs and therapies in language they can understand, not ads from pharmaceutical companies wiho stand to profit.

What about journals for lay people that summarize the material contained in our professional journals (minus the ads, of course)?