The fact that your life would be easier if you could trust someone does not make that person trustworthy. Doctors are a good example. Wednesday’s Post: The first-of-its-kind survey of more than 1,600 physicians, published today in the
It's wonderful how a lawyer schmoozing and lying his way through his profession is pleasant confirmation of our steretypes, but a doctor referring a patient to a centre in which he has an interest is a massive shock. It's akin to calling Britney a terrible mother while stuffing your kid with chips and white bread. People are not automata. They will protect their own interests, they will be lazy, they will lie, and they will be contradictory. They will do this whether they are lawyers, doctors, aid workers or soldiers. Should we scrutinise the medical profession due to its immense power? Yes. Should we expect a higher moral standard of doctors than we demonstrate in our daily lives? Good luck.
problem is : if we fired every doctor who ever made a bad mistake... then we'd have no doctors. So we'd be worse off.
So:- too few cover ups: maxuimum exposure, too few doctors- too many cover ups: incompetent doctors (who make more-than-average-errors) continue to practive.
With some assumptions about error rates It shouldn't be too hard to construct a mathematical model that shows what is the optimum level of cover-up.
Stuart: I'd say its probably realistic for patients that have been seeing the same doctor for 5-10 years, then lose health insurance for a year or two. The physician they already have a relationship with, will often continue seeing them at minimal charge. In that context, I'd believe the 70% statistic.
When I worked in a hospital I saw some things that shouldn't be. A major source of the difficulty, it seems to me, is the way doctors who do get reported are treated.For example, a doctor who has been giving excellent care for years might make a mistake. Other doctors might want to report that mistake, but if they do a malpractice suit may follow, ruining a good doctors career and driving up all their costs of doing business.Another scenario is when the doctors figure this not so good doctor is better than none at all. This is a sad situation caused by barriers to entry to the medical profession.And of course there are those who just get away with murderous malpractice- (a smaller subset of the total than one might expect from the statistics quoted).
But there's something very interesting about the ways doctor's are flawed. With one exception, the flaws are not something that a current patient of the doctor would understand as a betrayal (the one exception is a majority said they would refer patients to an imaging facility in which they had a financial interest, but that's borderline - as long as the doctor convinces himself that the imaging is needed, then he can justify to himself that that isn't a violation of trust).
It seems that doctors are strongly motivated to avoid looking a patient in the eye and doing something that patient would take as a betrayal. It seems the statement "I can trust my doctor" is more true than "doctors can be trusted".
Incidentally, is the statistic 69 percent currently accept uninsured patients who are unable to pay reliable? That seems absurdly altruistic...
In terms of imaging, a lot of the problems are that the financial incentives for physicians are not lined up with delivering efficient care. The new Medicare report on reimbursement notes that the system actually punishes physicians that use resources wisely.
What about my lovely doctor friends, who smoke and drink too much. One of them was an emergency doctor who regularly drank way too much after working hours to cope with stress. (He also told me that I would die because of my tachycardia. I had hurt him when I was younger, did not want to go to bed with him). One of them is my best friend, she smokes 20 cigarettes a day, while she has to ask people to get off smoking. Another one is on some form of drugs, don't know if it is some morphine. Another loves goose liver pate and all the other (lovely) fatty substances.It is a hard life for doctors, nowadays.
...pretending to be authorities far beyond their actual expertise.
I've noticed this in arguments on the web about medical matters. Most people are completely unwilling to evaluate logical arguments on the subject and will defend existing practices to the point of absurdity, seemingly by default.
Most doctors aren't willing to analyze what they do either, in my experience, but at least there are good reasons for that.
Ben: Perhaps we should expect a lower moral standard of doctors (and reward them accordingly).
Doctor hypocrisy? Surely the title you were looking for was 'Hippocrisy'.
[Very pleased with that one!]
It's wonderful how a lawyer schmoozing and lying his way through his profession is pleasant confirmation of our steretypes, but a doctor referring a patient to a centre in which he has an interest is a massive shock. It's akin to calling Britney a terrible mother while stuffing your kid with chips and white bread. People are not automata. They will protect their own interests, they will be lazy, they will lie, and they will be contradictory. They will do this whether they are lawyers, doctors, aid workers or soldiers. Should we scrutinise the medical profession due to its immense power? Yes. Should we expect a higher moral standard of doctors than we demonstrate in our daily lives? Good luck.
problem is : if we fired every doctor who ever made a bad mistake... then we'd have no doctors. So we'd be worse off.
So:- too few cover ups: maxuimum exposure, too few doctors- too many cover ups: incompetent doctors (who make more-than-average-errors) continue to practive.
With some assumptions about error rates It shouldn't be too hard to construct a mathematical model that shows what is the optimum level of cover-up.
Mark Miller suggests using the term "vulnerable" in place of "trusted" in certain situations.
Stuart: I'd say its probably realistic for patients that have been seeing the same doctor for 5-10 years, then lose health insurance for a year or two. The physician they already have a relationship with, will often continue seeing them at minimal charge. In that context, I'd believe the 70% statistic.
When I worked in a hospital I saw some things that shouldn't be. A major source of the difficulty, it seems to me, is the way doctors who do get reported are treated.For example, a doctor who has been giving excellent care for years might make a mistake. Other doctors might want to report that mistake, but if they do a malpractice suit may follow, ruining a good doctors career and driving up all their costs of doing business.Another scenario is when the doctors figure this not so good doctor is better than none at all. This is a sad situation caused by barriers to entry to the medical profession.And of course there are those who just get away with murderous malpractice- (a smaller subset of the total than one might expect from the statistics quoted).
It seems the statement "I can trust my doctor" is more true than "doctors can be trusted".
And that might be why it's so hard to get people to see that there's a problem...
Which lets them get away with ...
Violating trust and keeping their image intact.
But there's something very interesting about the ways doctor's are flawed. With one exception, the flaws are not something that a current patient of the doctor would understand as a betrayal (the one exception is a majority said they would refer patients to an imaging facility in which they had a financial interest, but that's borderline - as long as the doctor convinces himself that the imaging is needed, then he can justify to himself that that isn't a violation of trust).
It seems that doctors are strongly motivated to avoid looking a patient in the eye and doing something that patient would take as a betrayal. It seems the statement "I can trust my doctor" is more true than "doctors can be trusted".
Incidentally, is the statistic 69 percent currently accept uninsured patients who are unable to pay reliable? That seems absurdly altruistic...
Konrad, Caledonian and peatey finished the sentence adequately.
Which lets them get away with ... murderous malpractice?
In terms of imaging, a lot of the problems are that the financial incentives for physicians are not lined up with delivering efficient care. The new Medicare report on reimbursement notes that the system actually punishes physicians that use resources wisely.
What about my lovely doctor friends, who smoke and drink too much. One of them was an emergency doctor who regularly drank way too much after working hours to cope with stress. (He also told me that I would die because of my tachycardia. I had hurt him when I was younger, did not want to go to bed with him). One of them is my best friend, she smokes 20 cigarettes a day, while she has to ask people to get off smoking. Another one is on some form of drugs, don't know if it is some morphine. Another loves goose liver pate and all the other (lovely) fatty substances.It is a hard life for doctors, nowadays.
...pretending to be authorities far beyond their actual expertise.
I've noticed this in arguments on the web about medical matters. Most people are completely unwilling to evaluate logical arguments on the subject and will defend existing practices to the point of absurdity, seemingly by default.
Most doctors aren't willing to analyze what they do either, in my experience, but at least there are good reasons for that.
cliffhangers and unannounced 2-parters. I feel like I'm watching Falcon's Crest.
Get away with what, exactly?