Listening to the Patient


As we talk about -- yes, even shout about -- health care reform, one of the issues that keeps cropping up, but which gets little attention is the way medicine is practiced today. With a profit incentive in the system, medicine rewards doing over thinking and listening. We've come to the point where the majority of physicians are specialists, not Family Practitioners. Therefore, when we go to the doctor, an overloaded system, doesn't have much time to listen and consider what's going on. So, we get referred on to specialists and have expensive tests prescribed.

What is interesting is that this may not be the best way to practice medicine. I heard a fascinating interview today on NPR's Fresh Air. It was an interview with Dr. Lisa Sanders, author of a new book called Every Patient Tells a Story, and she's the primary medical consultant for the award winning medical drama House (Fox TV).

The transcript of the interview that I just heard isn't up yet, but Dr. Sanders notes that doctors have neither the patience nor the encouragement to listen, but in doing this they often miss symptoms that could give a better diagnosis. She also talked about the demise of the physical examination -- which society no longer values, due to our reliance on tests. But often physical exams can provide better tools and ideas for a diagnosis, without possibly requiring expensive tests and X-Rays. But, again the system doesn't reward listening -- just doing something.

If we're going to have real reform, I think we need to pay attention to this first level kind of medicine. We need to revalue it, and encourage prospective physicians to go into this kind of medicine! It may not pay as much, but the potential for good is immense!

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