Patient Choice Is A Good Choice, Part 2
"This isn't right.
This isn't even wrong" -Wolfgand Pauli - legendary physicist Our senses and common sense work pretty well on distance scales we encounter in our daily lives.
However, at very small or very large distance scales, modern physics demonstrates that our intuitive understandings completely break down.
Quantum mechanics and general relativity make no sense without the mathematics, which take many years to learn.
Anyone who tries to evaluate the truth of the physics first needs to understand the mathematics, or they will not "even be wrong" but speaking nonsense.
Judging medical quality is similar in many ways.
Some types of medical care that can be well evaluated by laymen using common sense and outcomes.
Did the Pediatrician cure the ear infection? Did the Podiatrist fix the toe problem? Did the Chiropractor relieve the back pain? In fact, for certain types of medical care, the opinion of the patient is the only measure of any importance.
On the other hand, some areas of medicine are so complex as to make patient opinion irrelevant.
For instance, in the last 15 years, the treatment of bleeding aneurysms(small congenital vessel deformities) has completely changed.
At one time surgeons had to open the skull and dissect out the vessels in very dangerous surgeries.
Now, tiny metal coils are placed by Radiologist using catheters inserted from the leg.
The procedure is most difficult, requiring extensive training and sometimes does not succeed.
Furthermore, the patient is usually comatose prior to the procedure, and is always sedated.
Only another trained expert can even understand what was done, much less judge the quality.
What the patient thinks about the procedure is not important.
The only criteria the patient can evaluate is how they were treated before and after the procedure by the nurses, or whether they liked the doctor if they wake up.
Many areas of medicine are similar.
Surgical and medical sub-specialties involve expertise and knowledge which is simply not accessible to layman or even other physicians.
I used to joke that I worked with Radiation Oncologists every day for 25 years and still never understood what they did.
How could a patient judge? Unfortunately, these distinctions are lost on the bureaucrats that have taken it upon themselves to judge medical quality.
In the article referenced today, new policies will tie hospital compensation to patient evaluations of medical quality.
Patients are simply not in a position to evaluate many aspects of medical quality.
Instead, they will comment on what they can understand.
Things like food quality, newness of the sheets, and wait times for registration will become more important than the quality of the doctors or operating rooms.
This will begin yet another set of perverse incentives to make patients happy, rather than to get them well, which is not always the same.
One of the greatest sources of doctor frustration is how authorities have put layman in positions of power on medical boards and malpractice juries.
People without training, no matter how well intentioned, cannot understand or make intelligent judgments about some types of medical care.
Instead, they try to apply common sense, or something they do understand, which is often reflected in the crazy decisions which are sometimes made.
Unfortunately, like physics, such reasoning is not right, it is not even wrong, it is simply nonsensical, much like Obamacare.
http://www.
medpagetoday.
com/Washington-Watch/Reform/26200
This isn't even wrong" -Wolfgand Pauli - legendary physicist Our senses and common sense work pretty well on distance scales we encounter in our daily lives.
However, at very small or very large distance scales, modern physics demonstrates that our intuitive understandings completely break down.
Quantum mechanics and general relativity make no sense without the mathematics, which take many years to learn.
Anyone who tries to evaluate the truth of the physics first needs to understand the mathematics, or they will not "even be wrong" but speaking nonsense.
Judging medical quality is similar in many ways.
Some types of medical care that can be well evaluated by laymen using common sense and outcomes.
Did the Pediatrician cure the ear infection? Did the Podiatrist fix the toe problem? Did the Chiropractor relieve the back pain? In fact, for certain types of medical care, the opinion of the patient is the only measure of any importance.
On the other hand, some areas of medicine are so complex as to make patient opinion irrelevant.
For instance, in the last 15 years, the treatment of bleeding aneurysms(small congenital vessel deformities) has completely changed.
At one time surgeons had to open the skull and dissect out the vessels in very dangerous surgeries.
Now, tiny metal coils are placed by Radiologist using catheters inserted from the leg.
The procedure is most difficult, requiring extensive training and sometimes does not succeed.
Furthermore, the patient is usually comatose prior to the procedure, and is always sedated.
Only another trained expert can even understand what was done, much less judge the quality.
What the patient thinks about the procedure is not important.
The only criteria the patient can evaluate is how they were treated before and after the procedure by the nurses, or whether they liked the doctor if they wake up.
Many areas of medicine are similar.
Surgical and medical sub-specialties involve expertise and knowledge which is simply not accessible to layman or even other physicians.
I used to joke that I worked with Radiation Oncologists every day for 25 years and still never understood what they did.
How could a patient judge? Unfortunately, these distinctions are lost on the bureaucrats that have taken it upon themselves to judge medical quality.
In the article referenced today, new policies will tie hospital compensation to patient evaluations of medical quality.
Patients are simply not in a position to evaluate many aspects of medical quality.
Instead, they will comment on what they can understand.
Things like food quality, newness of the sheets, and wait times for registration will become more important than the quality of the doctors or operating rooms.
This will begin yet another set of perverse incentives to make patients happy, rather than to get them well, which is not always the same.
One of the greatest sources of doctor frustration is how authorities have put layman in positions of power on medical boards and malpractice juries.
People without training, no matter how well intentioned, cannot understand or make intelligent judgments about some types of medical care.
Instead, they try to apply common sense, or something they do understand, which is often reflected in the crazy decisions which are sometimes made.
Unfortunately, like physics, such reasoning is not right, it is not even wrong, it is simply nonsensical, much like Obamacare.
http://www.
medpagetoday.
com/Washington-Watch/Reform/26200
Source...