Happy New Year. Time for new year’s resolutions. Let’s resolve to do our part to make American medical care the best it can be. You can help today by giving your doctor the feedback he or she needs to do what they most want, to give their patients great medical care. Go to www.DrScore.com today and complete a brief survey on your experience with your doctor.
States across the country are facing budget crises. With health care spending being such a large part of state budgets, cuts to health care expenditures are surely coming. Arizona has proposed a number of measures to cut costs. One is a fee charged to Medicaid-enrollees who engage in unhealthy activity. Another is to cut payments for organ transplantation. In Physician Practice magazine, editor Bob Keaveney decried the cuts.
Keaveney makes good points about how so called “death panels” in the health care legislation were bogus but that real death panels are happening when states decide not to cover organ transplants. But can we continue to pay for everything? Probably not. At some point, we have to recognize that paying for those transplants comes at the cost of not paying for other things we’d like to have. The people who have to make these choices are not in an enviable position.
In 1999, the Institute of Medicine reported big risks in American hospitals. Since then, there have been dedicated efforts to reduce those risks. Are things getting better? A recent New England Journal of Medicine article says no. You can more about the study with its author, Dr. Christopher Landrigan, on Getting Better Health Care.
The FDA approved a new drug, ipilimumab, for patients with metastatic melanoma. Advanced melanoma is a terrible condition for which there is little in the way of effective treatment. Ipilimumab clearly improves outcomes of this horrible disease with improvement in median survival from 6 months to 10 in patients with advanced melanomas.
While the 6 month to 10 month median improvement is nothing to sneeze at, it isn’t a very high cure rate. And the cost of the drug: over $100,000 for a course of treatment. Is it worth it?
If I had advanced melanoma and a 3rd party way paying the cost of my medical care, I would say it was worth it. If I were paying myself? I’m not so sure. The high, high cost for drugs that provide marginal benefits is illustrative of the main problem with have with U.S. health care. Health care reform efforts that don’t address this central problem are going to solve our crisis. To learn more, visit http://www.drscore.com/downloads/Health_Care_Primer.pdf.
Satisfying patients is not just about making the right diagnosis and prescribing the right treatment. Patients need to know they are seeing a friendly, caring, professional physician. But how do patients know? It’s complicated.
Patients’ perceptions are affected by all sorts of variables. Researchers reporting in the Archives of Dermatology looked at what kind of dress patients expect from their physicians. It’s a moving target, changing with our culture. Ties and white coats—traditional doctor attire—aren’t uniformly recognized as needed any more. Some patients, especially kids, can do without them.
Still, physicians will do well to wear dress that communicates to patients the doctor’s professional, caring approach to patient care.