Advice for President Elect Obama on Health Care
Max’s advice for January 2, 2009
Dear President Elect Obama,
Max grew up as the son of a man who knew ‘ALL’ the answers to the problems of the world. Max’s father said so! Many times, his father let everyone know that anyone who didn’t know that he had the answers was a turkey or a knucklehead.
The famous Ma Bell, the second most powerful force in the world (next to God of course), thought so much of Max father’s opinions, that the made him ‘Supervisor of Troubles’. This is true!
The advice Max promised you, Mr. President Elect.
Max advises that you may want to suggest to your choice for Secretary of Health and Human Service, former U.S. Senator Tom Daschle, focus on diagnosis as low hanging fruit with a large payback potential.
Max has seen a consistent problem with healthcare in the area known as diagnosis. Max has personally experienced the danger created when doctors try to diagnose in areas where they lack expertise when dealing with Max’s own body.
When Max first began experiencing heart trouble, he went to a small community hospital where the physician staffing the ER was a general practitioner. The poor guy was way out of his league.
Max was busy experiencing some of the easier to notice symptoms of a heart attack. The doctor put Max on his waiting list while he treated several minor cases. Max knows now, though he didn’t then, that the first two hours is crucial for treatment if one expects to live.
After two hours of waiting, the sharp pain down Max’s left arm subsided and the crushing pain in his chest went away. Most likely the blockage cleared due to the relaxation. It was a year later that a similar incident brought Max to a large city hospital. There they cleared one total blockage with angioplasty.
Max was lucky; he was only misdiagnosed one time for this particular ailment.
Max’s wife was misdiagnosed as not having a problem. She wisely disagreed and went to another doctor. A second opinion found the cancer. A large percentage of women would have stayed with the first opinion and ended up dying. No one would hold this doctor accountable for the slight mistake. It didn’t look serious after all!
Max and his wife have been lucky in spite of their misdiagnoses. A lot of Americans are not so lucky or assertive. Many go to doctor after doctor with symptoms that are not properly diagnosed.
Trips to the emergency room, tests (expensive ones) for the wrong thing, unnecessary stays in the hospital, lost days at work and emotional depression are just a few of the costs.
To their credit, a few of the larger hospitals are getting better in this area. However, the common problem of doctors not admitting that they do not know what is wrong with the patient is costing patients and the system untold amounts of money and sometimes lives.
Reports from various medical organizations cite misdiagnosis rates ranging from 20 to 40 percent. In the case of very young infants with appendicitis, the rate jumps to an alarming 100%. This means that no less than 1 time out of 5 the patient will get the wrong treatment or, like Max, may go with no treatment while the condition worsens.
It would not take much to hold physicians to a standard that says that if they do not know what is ailing the patient, they must send the patient for a diagnostic run up. This would provide hospitals with an offset for lost revenue from unnecessary visits to the ER while switching to a system that should result in more patients being treated for what truly ails them.
If a doctor is unsure or does not have enough information to diagnose the problem, they should own up to it. That should be the new ‘gold’ standard.
One office visit with no diagnosis and a diagnostic panel on each unknown problem should cost considerably less over time than multiple doctor and ER visits with no successful outcome. Both money and lives could be saved with this approach.
A panel of doctors, nurses, researchers and other key medical people could probably define a process that would work without offending the sensibilities of their peers. It should also provide for fewer malpractice suits and unnecessary tests on people who are properly diagnosed.
The advantage of hitting this area quickly is that payback could start immediately and there is no need for changes in the law. Only the ‘Gold’ standard for care is involved. This is completely in the hands of the existing medical establishment and patient advocates.
Link one is an article on Secretary select Tom Daschle.
Link two is information on Secretary select Tom Daschle.
Link three provides information on Misdiagnosis Statistics.
Max wishes you well in all your choices.