"Medical care is an area in which crucial decisions — life and death decisions — must be made; yet making those decisions intelligently requires a vast amount of specialized knowledge; and often those decisions must also be made under conditions in which the patient is incapacitated, under severe stress, or needs action immediately, with no time for discussion, let alone comparison shopping," he wrote.
"The idea that all this can be reduced to money — that doctors are just people selling services to consumers of health care — is, well, sickening. And the prevalence of this kind of language is a sign that something has gone very wrong not just with this discussion, but with our society’s values."
I understand the motive behind this semantic urgency to empower patients to have more say in their care process and choose where and what kind of care they get. But in my opinion, most patients are the last to know where to go to obtain care or whether high quality services are being delivered.
Let's be honest. How does anyone receiving care know whether the right tests were ordered, the right diagnosis given, the correct drugs prescribed or that the surgery went without a hitch? They don't. There is no "Consumer Reports" for this year's model of care from St. Hospital. People need to rely on medical professionals to guide them to the correct course.
Of course, transparency in value ratings for hospitals and doctors and price lists will help a lot, but they may be out of date, not readily accessible or risk-adjusted and irrelevant when you're gasping in the ambulance.
Yes, providers need to listen a lot better than they have been. And patients need to feel it's okay to ask questions. But still....
I asked Robert Wachter, MD, Associate Chairman of the UCSF Department of Medicine for some perspective, and he articulated some of what I have been thinking.