This is a question I am often asked when speaking to groups. Here is a simplified answer.
If you have had much contact with the medical system over the years you have seen how much things have changed; how complex the system has become, and how difficult it can be to obtain a diagnosis or feel comfortable you are on the right treatment plan. Most people know someone who has experience a medical error or encountered difficulties in their care. Most of the difficulties people are experiencing are not the fault of any one person. The problems are "system" problems. What do I mean by that?
System problems are difficulties that occur because the processes and mechanisms by which people do their work are not as effective or efficient as they need to be for good outcomes. Fifty years ago medicine was pretty simple, but as discoveries were made and the body of knowledge became so large it was impossible for one doctor to know everything, they began to specialize in fields such as nephrology (kidneys), gastroenterology (digestive system) and gynecology (women's issues). Many new tests and treatments were developed. Because all of this happened gradually over time:
• The system grew very fragmented - in disconnected pieces
• Information began falling through the cracks
• Doctors could no longer communicate effectively
• Errors became more frequent
• Law suit increased with increasingly large awards
• Doctors practiced defensive medicine
• New treatments and tests became more costly
• Complexity and duplication, among other things caused and are causing costs to increase
• And so on...
I think you get the picture.
People don't know what they don't know.
Because of this complex and gradual evolution over time many people, especially those over 50 years of age, haven't stopped to think about how this evolution has impacted them. My experience in interacting with folks during speaking engagements is that many still think of medicine and their doctors as they thought of them in the 40's, 50' and 60's. They still have them on a pedestal, are afraid to ask questions and don't understand what and how to provide information. Many are willing to learn what they need to do to obtain better health care and prevent errors in today's system, but many don't think it's necessary.
One of my realizations is that "People don't know what they don't know." Therefore, they don't understand WHY they need to think and behave differently and learn how to be a better patient or caregiver.
We Need a Culture Change
Two terms are being used by patients and providers who are trying to effect a culture change; change in the way patients and doctors think about and interact with each other.
• e-Patient, with the "e" standing for engaged, equipped, enabled, and empowered
• Participatory Medicine meaning that patients are actively involvement in their care and doctors are encouraging that involvement
These are words I'd like you to be aware of as they are starting to appear in the media. I encourage you to read or listen to the discussions about them as they appear before you. I will write more about them in later "Share" posts.
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