Comments on: Doctors need to fix the health care system that they had a hand in breaking

By: me

me — Sat, 17 Oct 2009 21:37:33 +0000

where are all these patients going, considering that suboptimal CYA medicine is pretty much the only available option? abroad?

By: Melgirl

Melgirl — Sat, 17 Oct 2009 20:10:10 +0000

@Doc99 …typically condescending. Feel free to cling to your wailing and gnashing of teeth over the Tort threat. I get it. It’s awful. But increasingly, you will see a diminishing number of your patients willing to lay down for sub-optimal care for the sake of CYA medicine.

By: Doc99

Doc99 — Sat, 17 Oct 2009 16:27:23 +0000

@Melgirl … Charmingly naive.

By: Dan

Dan — Sat, 17 Oct 2009 11:57:48 +0000

Anesthesiologists are doctors and went to medical school where they are taught to do a history and physical, and yes, anesthesiologists do histories and physicals. As a matter of fact, probably more thoroughly than most primary care docs since we are not focusing on a specific problem. We pick up murmurs, melanomas, bruits, etc. with regularity. I was often told by patients that I did the most thorough H&P they’d ever had.

By: son2

son2 — Sat, 17 Oct 2009 11:40:38 +0000

Wait, do anesthesiologists do histories and physical examinations? It’s a valid message; we need to get back to basics.

But why is it coming from an anesthesiologist?

By: Melgirl

Melgirl — Sat, 17 Oct 2009 02:38:54 +0000

Nice to see this kind of accountability. If you look at maternity care in particular, we see all sorts of “snake oil” being sold to women. Continuous fetal monitoring, taking the baby before he gets “too big,” cesarean for almost any reason or none at all – these practices set up the expectation of improved outcomes, yet maternity care in the US is failing miserably at improving the lot of women and babies. So, yes, we need to stop relying on technology that holds false promise and the physician community has got to it’s part and stop clinging to the “trial lawyer made me do it” mentality.

By: Classof65

Classof65 — Sat, 17 Oct 2009 01:13:04 +0000

I’ve always envied the President of the United States because…… once a year (at least) he gets a full physical exam at Walter Reed Hospital! I’ve never had what would be termed a “full physical exam.” No one has ever taken a full physical history of me. When you make a doctor appointment you’re always asked why you need the appointment. Then, when you see the doctor, the focus of the appointment is all that is addressed. Even now, my current doctor does this. She is caring and knowledgeable, but there is only so much time allotted to an appointment and so that’s all that is addressed.

I doubt that this is going to change. Doctors do not have time to sit and talk with a patient for hours. And, even if they did, my memory is not as great as it used to be! But I still envy the President…