One of the latest trends I’m finding in trying to get Kaiser to do something, anything to deal with AD, is this tendency to scoff at the information that the current research is showing. Golden little nuggets like “oh, that’s just a bunch of research mumbo jumbo” or, “researchers like to think they know about medicine, but they don’t see patients” or “research doesn’t apply to clinical care”.
Excuuuuuuse me? This is Kaiser, right? Kaiser Permanente? The if we don’t have 20 years of studies conducted by every research institution in the free world then it isn’t true Kaiser Permanente?
Since when did Kaiser (at least here in the Pacific Northwest) become so hostile to research and researchers?
Even the concept of evidenced based medicine worries me. Of course it should be paramount. I certainly don’t want my doctors taking blind stabs in the dark just for the sake of looking busy.
The problem is, we don’t know it all. We have not reached the end of the internet (er, medical research). Not even close. We haven’t even mastered the diseases we’ve been grappling with and funding for decades, let alone those lower on the totem pole.
So what then? What if you have an illness medical science hasn’t been able to research yet? Under evidence based medicine, do we give up? Throw up our hands?
For the most part, that’s been my experience. Symptoms we can’t explain? Oh well. Health problems we can’t name? Too bad. Once I had a diagnosis, it got easier, at least where the major research is conducted. I’m not sure what the difference is between these places and Kaiser, except that in the process of gathering all the evidence for this evidence based medicine, you have to use logic and reason to even get to the point of having something worth researching. Perhaps trial and error, figuring things out, and using similar/related diseases is just second nature.
Why the Kaiser doctors I’ve seen lately see fit to throw up their hands while scoffing at researchers is beyond me.
Of course this tends to be a glaring blind spot in the modern practice of medicine. I’m never sure which shocks me more, the young doctors incorporating old school signs and symptoms into their work, or the doctors who wouldn’t know them if they bit them on the rear, and rely exclusively on lab work to tell them what is or isn’t wrong, and what to do about it. Medicine by the book. Except the book is an infant’s alphabet board book in the face of a universe of complexity that is the human body.
Our knowledge of the human body is still in it’s early stages, and the target of knowing everything we need to know moves further out of reach with each step forward. The more we know, the less we understand. It won’t always be this way, I know, but in the meantime, a lot of people suffer or die on the altar of a slavish devotion to evidence based medicine.
Of course EBM should be the first line of defense. But it can’t be the only weapon in our arsenal.
Medical providers have lost sight of what they are there for, which is to provide health care. The health care industry (and it is an industry) is being squeezed by for profit aspect of the business. Insurance companies want to pay as little as possible for services rendered. Hospitals want to make as much profit as possible so both are cheery picking their clients. The prefect client is one that doesn’t require health insurance. One that is a drain on the bottom line is normally dropped from the health insurance provider.
With this said the Pacific Northwest which doesn’t have the resources wants to limit service anyway they can. A doctor is the first line of defense for the hospital and insurance company so it is in their best interest to inhibit any access to new expensive technology.
The complexity of getting good medical service is difficult when a person is healthy, almost impossible when unhealthy or lack medical insurance. It is a strange world we live in when a persons health care is based on profit not availability.
Very well said, with a few caveats:
There are very few hospitals that are for-profit, and of those that are, not all of them are profitable. There are some notable exceptions.
The many public and private not for profit hospitals impress the hell out of me with their ability to do more with less (some notable HMO models that use undisclosed fee structures and primary care, for profit gatekeepers to deny coverage aside). Some of the best care I’ve ever received in my life has been at these public hospitals.
The doctors to a large degree are victims of the same perverse system that has left patients hanging in the wind. The practice of medicine has become survival of the fittest. I can’t really blame most doctors for trying to survive. If there weren’t some survival instinct in them, they’d now be plumbers and we’d really be screwed.
Ambulance chasers in my opinion deserve a special place in hell for chasing the chum, instead of justice.
For profit insurers are a waste of human flesh, in corporate form.
Then there’s Henry J. Kaiser, and his all-you can eat health care buffet, which is the Wal-Mart of health care. Using the economies of scale to drive out competition, and pawning an inferior product off on an unsuspecting customer base.
It’s interesting to note the spread of Killsya Permanently as compared to the increase of health care spending.
It’s really all a kettle of red herrings. Point blank: we spend too much, and get too little. We value profit more than life.
What does that say about us? Where are all those pro-lifers who get so up in arms about abortion? Do innocent adults dying from for-profit medicine not concern them at all? How about innocent children dying from for-profit medicine?
Hypocrisy, thy name is neo-con.