Tag: Health & Care

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Health Care Dilemma | Responsibilities of Patients

I am penning down some of the responsibilities of the patients too in order to correct the system. Find a doctor who communicates Most of us need a doctor who can clearly explain what ails us and the possible ways to treat it. If you have a physician who does this, stick with him or her. If your current doctor tends to rush you or doesn’t explain things well, tell him or her you need more time. Coordinate your own care Talk to your primary care doctor about making sure he or she sees copies of your medical records from all your various doctors. Somebody besides you needs to know what all your physicians are doing—including all procedures, tests, and drugs they’ve prescribed. This is especially important if you are on multiple drugs or have a chronic condition, such as diabetes or an autoimmune disorder that requires visits to multiple specialists. Get the right specialist If you or a loved one is facing a serious illness; find yourself a doctor who shows interest in the cost friendliness of various solutions he is offering you. Find out what difference a test or procedure makes Ask your doctor what he or she expects to learn from the test and whether the results will make a difference in your treatment. Weigh the benefits and risks If a physician recommends a surgical procedure, ask what will happen if you decide not to do it—or if there is a less-invasive treatment option. No one believes that reforming our national health care system will be easy. In fact, it is likely to be painful and will take many years to implement.

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Health & Care | Looking for Solutions

There are no easy solutions, but let’s look at some of the critical areas where a change in practices—and attitudes—is needed. Health information systems Though the technology exists to put all of our medical records online, few hospitals or health care systems in the country have invested in it. In most hospitals, paper records not only waste time but also lead to duplication of effort, creating more costly errors. Many of tests and radiological scans are repeated simply because they can’t be located or can’t be transmitted from one doctor to another in a timely fashion. Shared decision making A better solution would be reforms that encourage doctors to spend the time needed to explain to patients the tradeoffs between potential treatments. This kind of interaction could provide more personalized medicine and would also reduce unnecessary care. Evidence suggests that patients who are truly informed about the risks and benefits of a treatment or a test are more satisfied with the choices they make and often less likely to want expensive invasive procedures. Evidence-based research It is essential that we gather better scientific evidence for what works in medicine, what doesn’t, and for which patients—and get the word out to doctors. New ways of paying doctors and hospitals To avoid falling into the fee-for-service trap, many of the health care systems that offer the highest quality care have their doctors on salary. Offering decent salaries to primary care doctors would save money by encouraging them to spend the time needed to provide high-quality, low-cost care.

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Health Care Dilemma | Who is Responsible?

Many physicians believe that demanding patients are the reason they are delivering so much unnecessary care. Patients insist on getting a prescription for a drug they saw advertised on TV, or on getting an unnecessary and pricey imaging test, such as a CT scan. Doctors fear that the patient will leave them for another physician or because explaining why a drug or a test is unnecessary takes too much time. You have a patient who comes in with hearing loss. It might be an acoustic neuroma, a very rare [slow-growing] tumor. Some doctors order an MRI for every patient who walks in the door complaining of hearing loss. But a more rational approach is to explain to the patient that there is only a small chance of a tumor. The doctor should say, “Let’s check your hearing in six months.” But many doctors don’t do that, because they worry the patient will go to a physician down the street, who will find a tumor, and the patient will turn around and curse the doctor who suggested waiting. There are other hidden forces pushing over treatment. In many private facilities there are more specialists and more hospital beds than necessary, and the doctors tend to practice more-aggressive care, hospitalizing patients unnecessarily and referring their patients to other specialists, who then perform more unneeded procedures and tests. Sometimes, providers deliver unneeded care because they get paid more when they do more. Most of our caregivers are still paid through a system known as fee for service. They are reimbursed for each office visit, each day a patient spends in the hospital, and each test or surgery performed. This means that health care providers have every incentive to give patients more care, not better care. In our part of the world doctors are the professionals devoting most of their lives to service but they are not getting fair economic returns and privileges. Their minds are being polluted by the corporate culture of pharmaceutical industry and the deprived doctors find them a last resort to maintain a respectable lifestyle for themselves and their families. The insensitivity of our system towards health care has also increased the cost of health care and the doctors find themselves sandwiched among health managers and consumers.

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Health Care Dilemma | Cost & Quality

Every day, people die due to lack of access to sufficient medical care. Health care costs have soared in the past several years, posing a dilemma for everyone, especially those who have financial difficulties. Why does basic health care cost so much? What do we get for all that money? Let’s look at a few facts as an example:

Infant and maternal mortality rate in Pakistan is the highest among SAARC countries and one child dies in the country every minute from EPI disease, diarrhea and acute respiratory infections.

The World Health Organization (WHO) has estimated that the out-of-pocket health expenditure in Pakistan stands at 71 per cent — the highest in the Eastern Mediterranean region — and a burden for the poor.

The unregulated private sector delivers a high proportion of health services and there is a great discrepancy in the quality of services.

Those who can only afford to pay a little usually get the poorest quality of the services, says a World Health Organization review on health inequalities in Pakistan.

In rural areas, the very poor women and men avail government services as they can afford only those.