Friday, June 5, 2015

Family Medicine: Let's Dialogue to Fight Impending Healthcare Disaster

Healthcare: Disaster of Inadvertence

What's up (or down) in healthcare?
I discuss it on my Dr Synonymous BlogTalk Radio Show at the link above.

I review a blog post by Dr Elaina George that expresses some of the dilemmas facing us in healthcare.  A bleak near future is coming.  Let's hang on AND develop radical strategies to bypass the "inadvertent" mess.

Dialogue is one of the keys to health care success.  Family Physicians should help patients to dialogue about their uniqueness in the context of their individual lives.  Patients should dialogue with persons in healthcare with whom they have contact.  We all need to share what's really important to us and seek to discern meaning in our health/ disease situations. The uniqueness of our individual identities must be clarified and honored in our interactions- both in life and in healthcare situations.

The dishonoring of  human values in the healthcare system is rampant and must be countered with dialogue.  Exposure to unnecessary testing, especially radiation via imaging such as CT scans is generating about 30,000 cancers per year according to the American Cancer Society.

"The rise in radiation exposure due to medical imaging is a cause for public concern because of cancer risk. Imaging techniques that use ionizing radiation (such as CT scans) have the potential to cause cancers to form, and because of the increased use of these techniques over the last two decades, some estimates predict that 2 percent of all future cancers will result from current imaging use.
In their study, Smith-Bindman and her colleagues examined the health records of millions of patients in several western and Midwestern states who participate in six large integrated health care systems. This was the first major study to look at how radiation exposure has increased within these private systems. The collaborating health care systems are all part of a consortium of 19 HMOs across the United States and in Israel called the HMO Research Network, which has made a commitment to conduct research to improve the health care they provide to their members.
To the researches’ surprise, for patients in these systems, just as in the rest of the U.S. population, the average amount of radiation has increased over the last two decades. The new study showed a doubling in imaging rates, and by 2010, for every 100 adult patients, around 20 CTs were performed. Older patients underwent even more CT scans. For every 100 patients age 65 to 75, around 35 CTs were obtained."  From the UCSF newsletter 2012
Physicians routinely don't get informed consent from the patient to perform most CT scans.  Won't this come back to bite physicians and hospitals when the public realizes the harm done?

The principles of medical ethics reminds us of patient autonomy.  "First of all- Do No Harm" is a central tenet of medical practice.  Thirty thousand cancers sounds pretty harmful to me.  Not getting informed consent for a test that can lead to cancer doesn't sound like patient autonomy to me.

Dialogue is needed.  Let's get it going, Folks!

No comments:

Post a Comment