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Providers’ Eyes Remain Downcast (Part II of IV)

Posted Apr 08 2011 11:45am

This is the second of a four-part series that started by observing that you – fellow health care provider – have been ignoring a critically ill patient begging for our help. The quacks that have been malpracticing on this poor soul have consistently made her worse. The name of this nearly terminal Patient is Healthcare.

The first article – “ Provider–Raise your eyes ” – presented evidence of the Patient’s sickness and described the four principles of good medical practice not being applied to this Patient. I promised to explain the reason why we keep our eyes downcast, why care providers ignore this Patient.

There are four reasons generally given for keeping our eyes down. By far the most common is that we are too busy with individual patients to pay attention to The Patient. The old aphorism cannot see the forest for the trees seems apt for health care providers. Our eyes are so focused on the veins of one leaf on one tree that we do not see – rather than cannot see – the whole tree, much less the forest and certainly not the landscape.

I submit, with respect, that “too busy” is a cop-out. If you were caring for patient A with a bad cough and patient B came in having a cardiac arrest, would you be too busy to go treat B?

Some excuse themselves with, who am I to fix a sick system? I’m just a nurse or doctor. I take care of patients. Sick Healthcare is a matter for politicians, not me.

The best response is twofold. First, Healthcare is S. I. C. K . Yes, it is a system rather than a human. However, systems thinking – the cure for sick systems – is virtually identical to the practice of good medicine. Who better to do that than a good doctor or nurse? Second, consider what the Congressional ‘doctors’ have done with/to the Patient so far. Do you still think they are the right people to fix healthcare?

Some give the tired excuse that one person cannot do anything. Try that one on the Duke of Wellington, Adolf Schicklgruber (aka Hitler), Mao Tze Dung, or Li Kwan Yu.

It takes only few persons with passion to start a world-changing revolution. Recall your American history and think about Thomas Jefferson and Benjamin Rush, who was one of the five physicians among 56 signatories to the Declaration of Independence.

Finally, there are our colleagues who emulate the ostrich. They claim that PPAHCA (Patient Protection and Affordable Health Care Act of 2010) is a start and after all, a start is better than nothing.

While Congress is adept at disingenuous naming of Acts they pass, PPAHCA may be a new low (or high, depending on your viewpoint). It does not protect patients; it is the opposite of affordable; and it cannot provide care. Only nurses, doctors, and allied health personnel can do that.

To providers who think PPAHCA is a move in the right direction, I ask the following. Would it be okay if I gave a drug that lowers blood pressure to a patient in shock? True, I have no idea what is causing the shock (no etiologic diagnosis). True, I have no evidence that lowering blood pressure will help. Indeed, it may kill the patient, but hell, ‘at least it’s a start.’

If we providers are true to our oath to heal all those who are sick, then we must raise our eyes and take up the case of Patient Healthcare. If we do not, Patient Healthcare will surely die, taking both our patients and ourselves.

Before discussing what we need to do to practice good medicine on Patient Healthcare in Part IV, I need to answer a question that I hear over and over, a question many of you have asked yourselves. How did my calling turn in to a job (Part III)?

System MD

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