5 top medical comments, July 5th, 2009

Here are some of the more interesting comments readers have left recently.

1. Rogue Medic on how Oprah should be handling medical issues:
If she is going to give medical advice, and she is giving medical advice, and she is going to focus on giving advice contrary to the guidelines of reputable medical organizations, maybe some of her viewers need to start suing her for the bad medical advice.

I am guessing that she would seek the services of a real lawyer to deal with problems that come from promoting Dr. Jenny McCarthy, Dr. Jim Carrey, and the rest of the medical fringe. While there is much to be improved in medicine, the answer is not to come to the conclusion that the crazies in tinfoil hats have any kind of a clue.

People are dying because of this bad medical advice. Oprah should be ashamed.

2. William Hsu on whether alternative medicine works, or not:
I would like to say that I think most of benefits of alternative medicine are simply placebo effects.

But you know what, placebo effects can be beneficial to patients. If you perceive yourself to be less sick, what’s the difference to the patient whether it came from evidence based medicine or alternative medicine? I think the medical establishment should embrace alternative medicine to a degree because it often provides patients with the mental state of mind that will make them feel better. Placebo effects are better than doing nothing.

As long as the placebo is safe, affordable, and not used to replace evidence based medicine – the harm is minimal. The real issue is making sure the placebo is safe – this is where doctors need to step up.

3. Jennifer on what patients want from their doctors:
I am fortunate to have a very good physician. He has a great “bedside manner” and also is very knowledgeable.

I don’t know about other health consumers, but the way I see it, I want someone who will help me make the right choices for treatment or lifestyle choices.

Physicians are frequently very busy, have to deal with the HMO’s and probably want to deal with someone who has an understanding of what they want and what the problem is they are experiencing.

My vote would be for someone who is a partner in my health care. I have a good understanding of my condition, though I am by no means a medical expert and the main reason I visit physicians is for their advice on treatments and lifestyle changes.

4. Evan Falchuk on whether physician quality measures really can tell who’s a good doctor:
The problem with the plans for health care reform is that they are almost entirely focused on how health care is financed, not on how to help physicians and patients work better together. The administrative burdens alone of the new IT mandates will add new work to already over-stretched doctors offices. And we can also expect that reimbursements to doctors will continue to come under pressure, furthering existing problems with doctors having to see too many patients.

Doctors being paid to spend more time with their patients would probably do more to improve health care quality than any set of complicated performance metrics we can come up with.

5. Moof on how Twitter can strengthen the doctor-patient relationship:
One of my recent primary care physicians interacted with me through a secure email connection which is provided by the local hospital for all of their “associates”. It made a world of difference for me – I could drop my physician an email when things weren’t working right, or when I had a quick question about something we’d already discussed.

None of my other physicians use email … and it seems as if a door has closed for me. Twitter, email … WHATEVER … would be wonderful if they (or their office crew) kept a window open in that way.

However, there would have to be some remuneration … if this started to take chunks of time from the professionals involved, then there has to be some sort of limit, and also some sort of prearranged fee. The internet should not become a “freebie way” to reach your physician. Insurance companies would also need to begin covering that sort of care.

Finally, the sort of internet care that simply replaces the telephone – for example, calling in for a prescription refill, or changing an appointment date, should not become a fee driven service.