There are many levels of change that are required if we really want to change health care. Here are just a few with (hopefully) brief comment.
1-Culture: The idea that "I can do what I want and live the lifestyle I want and when I need to be treated, I should get all the treatment I need regardless if I can pay for it or not."
If you have something like open heart surgery and you continue to smoke, not exercise and refuse to change your life, then you don't get another shot...especially if it was on someone else's dime in the first place. People must decide to make an investment in their own health. There is personal responsibility required. Which brings me to the next thing...
2-Doctors should be able to tell you "no." They should be able to be brutally honest with their patients, and not get sued.
3- Consequently, I think there should be greater education on the "after surgery" part as much as what the surgeon will do when he is operating on you. The recovery is very much the patient's responsibility. But the doctors have to give a realistic picture of what that recovery will entail. I hear people all the time say, "If I knew it would be this hard or like this, I would not have done this."
4- An end to the " I deserve this" mentality. EX: Patient comes in, has smokes in his back pocket, hundreds of dollars of tattoos, the latest, most expensive smart phone, and has expensive clothing and yet tells you he cannot afford the blood pressure medicine. But the patient feels like he deserves your best service, to be fed, and pampered and can be rude to the staff.
WTF??? PRIORITIZE YOUR LIFE. Because now, since the person was too idiotic to spend his dollars in the correct spot (i.e. BP meds), this person has had a stroke from too high blood pressure, his right side no longer works and is now disabled for life. Wow, the blood pressure meds are looking PRETTY inexpensive now.
5-Frivolous lawsuits. Just because something bad happens does not always mean it is someone's fault. Life sucks that way sometimes. We need a screening panel of doctors, nurses, and non-medical people with at least a 4 year degree to review lawsuits to determine if it has merit or is just bullshit.
6- And with reference to #5, doctors need to be trusted. Doctors have to order ever damn test in the world to cover their asses even when their experience tells them the tests are unnecessary. But on the tiny, minuscule chance that something can go wrong, they do everything imaginable to cover their butt. And it's ALL expensive.
7- Tell you doctor the f'ning truth. Don't lie to him because your labs won't lie. "No, I haven't used cocaine in several months." Really? Then why is your toxicology screen positive for cocaine and marijuana AND barbiturates??? Just wondering. Just tell him the truth.
We need to remember something about medicine. The reason its called a Medical Practice is because that is what doctors and nurses are doing...they are practising.
Medical care is not a product - it is not something you buy that is pristine and perfect and if it does not do what you want, you get a refund. Medical care is a service and at times, it is really hard to do. The vast majority of service providers in health care are interested in caring for their patients to the best of their ability. But it is never perfect and never full proof. With honest communication (see #7), it can be a great service.
Lots has to change for health care to get better. That change has to be in the community, in legislation, in how docs get paid and with personal responsibility. So many levels of change...
Wish us luck!!
