Philosophy Discussion Forums | A Humans-Only Club for Open-Minded Discussion & Debate

[ah2838]

Much of this book required patients to assume the mindset of a consumer as opposed to a patient. Ideally, everyone should feel safe and secure when going to their provider but Barbara Galutia Regis made several points to rebut that claim. This may be a different way of thinking about healthcare, and even your provider. Should we, as patients, be constantly second-guessing professionals who have spent hundreds of thousands of dollars on their career, are more than likely in debt, went to school for at least 10 years, and have a true (hopefully) calling to their profession?

Also, should America's healthcare system provide a more personal approach to medicine or utilize a business model to maximize profits?

[Shecancervive]

I have only started reading the book but agree that we should question the professionals. I have had a rare cancer for ten years and had I not done my own research and questioned the pros I probably would not be here. So far I agree with the author.

I also believe healthcare that is on a more personal level tends to instill more trust than someone watching a clock and not getting to know their patients.

[RJAll]

After reading the book, my impression is not so much that we should constantly question professionals, but rather seek further advice (from other professionals) as needed when our symptoms don't improve. I'm a retired medical professional. While I genuinely enjoyed my work and caring for my patients, it really was hard work and stressful. I expected and received a good salary, and I believe each health care worker deserves that. However, the author is absolutely correct in her assertion that everyone should have basic health care coverage. Without it, the simplest care can be prohibitively expensive and more complex care financially ruinous.

[Sushan]

It is a good thing to be knowledgeable about the service that you are getting. But constantly suspecting or questioning your care giver will annoy them as well as they will see you as a nuisance. That does not mean that you do not have the right to question. If you pay (even if you do not) you have the right to know what will happen to your health and body. But as I believe, there is a mental component in treating patients as well. There are occasions in which same drug or treatment has produced different results in different patients. I think such unexplainable scenarios have something to do with the patient's mind as well. So if you suspect too much, it will weaken your own confidence as well. So I think it is good to be cautious, but not good to be too much suspicious.

[LuckyR]

It doesn't matter. There has been and there will always be a spectrum of patient tendancies. Some will go along with the doctor's opinion 100% and some 0% and every number in between. Trust me, healthcare providers have seen all types before, there is nothing you're going to question (second guess) or pull off of some website that they haven't heard (and dealt with) before.

It is silly to think that a doctor could change how individual patients handle information. It is equally silly to suppose that a patient armed with a book is going to fundamentally change how a professional manages their practice.

As to the second question, classic example of a false duality.

[Sushan]

I have only started reading the book but agree that we should question the professionals. I have had a rare cancer for ten years and had I not done my own research and questioned the pros I probably would not be here. So far I agree with the author.

I also believe healthcare that is on a more personal level tends to instill more trust than someone watching a clock and not getting to know their patients.

Your journey through a rare cancer and the proactive stance you took towards your health is indeed eye-opening. It underscores the crucial role of personal advocacy in navigating the healthcare system. It seems like a delicate balance between trusting the expertise of medical professionals and exercising one's own agency in ensuring the quality of care received. Your insight also brings to the fore the importance of a personalized approach in healthcare, which could potentially foster a deeper trust and understanding between patients and healthcare providers.

Can a middle ground be struck where the healthcare system can be both personally engaging and financially sustainable? Moreover, how do you think the dynamics between patient and provider might evolve if such a balance were to be achieved?

[Sushan]

After reading the book, my impression is not so much that we should constantly question professionals, but rather seek further advice (from other professionals) as needed when our symptoms don't improve. I'm a retired medical professional. While I genuinely enjoyed my work and caring for my patients, it really was hard work and stressful. I expected and received a good salary, and I believe each health care worker deserves that. However, the author is absolutely correct in her assertion that everyone should have basic health care coverage. Without it, the simplest care can be prohibitively expensive and more complex care financially ruinous.

Your perspective as a retired medical professional adds a rich layer to this discussion. It echoes the balanced approach suggested in the book of not incessantly questioning professionals, but rather seeking further advice when necessary. This stance seems to honor the expertise of medical professionals while also advocating for the patient's agency in their own healthcare journey. It's a nuanced approach that doesn’t undermine the professional but encourages a collaborative relationship.

Your remarks also touch on a fundamental issue - the accessibility of basic healthcare. It’s a poignant reminder of the real-world implications that the financial structure of the healthcare system has on individuals seeking care. The aspiration for everyone to have basic healthcare coverage seems grounded in a profound sense of equity and human dignity.

Considering your experience in the field, do you think there are models from other countries or certain reforms that could be integrated into the American healthcare system to achieve this balance between providing basic healthcare coverage while still ensuring that medical professionals are adequately compensated? How do you envision the interplay between policy reform and individual awareness or action, in moving towards a more equitable healthcare system?

[Sushan]

It doesn't matter. There has been and there will always be a spectrum of patient tendancies. Some will go along with the doctor's opinion 100% and some 0% and every number in between. Trust me, healthcare providers have seen all types before, there is nothing you're going to question (second guess) or pull off of some website that they haven't heard (and dealt with) before.

It is silly to think that a doctor could change how individual patients handle information. It is equally silly to suppose that a patient armed with a book is going to fundamentally change how a professional manages their practice.

As to the second question, classic example of a false duality.

Your response brings a pragmatic lens to the discussion, underscoring the vast array of patient tendencies and the seasoned experience of healthcare professionals in navigating these. It's a reminder of the deeply ingrained human behaviors and the complex dynamics at play in the patient-provider relationship.

You also highlighted a compelling point regarding the purported dichotomy between a more personal approach to medicine and a business-oriented model. It insinuates a richer landscape of possibilities that could potentially harmonize the values of care, trust, and financial sustainability.

It stirs a reflection on the potential pathways to foster a healthcare environment where both patients and providers feel understood, respected, and adequately supported. Could there be a middle ground that encapsulates the merits of both personal engagement and economic viability? And how might the stakeholders in the healthcare ecosystem work collaboratively to explore and manifest such a balance?

[LuckyR]

It doesn't matter. There has been and there will always be a spectrum of patient tendancies. Some will go along with the doctor's opinion 100% and some 0% and every number in between. Trust me, healthcare providers have seen all types before, there is nothing you're going to question (second guess) or pull off of some website that they haven't heard (and dealt with) before.

It is silly to think that a doctor could change how individual patients handle information. It is equally silly to suppose that a patient armed with a book is going to fundamentally change how a professional manages their practice.

As to the second question, classic example of a false duality.

Your response brings a pragmatic lens to the discussion, underscoring the vast array of patient tendencies and the seasoned experience of healthcare professionals in navigating these. It's a reminder of the deeply ingrained human behaviors and the complex dynamics at play in the patient-provider relationship.

You also highlighted a compelling point regarding the purported dichotomy between a more personal approach to medicine and a business-oriented model. It insinuates a richer landscape of possibilities that could potentially harmonize the values of care, trust, and financial sustainability.

It stirs a reflection on the potential pathways to foster a healthcare environment where both patients and providers feel understood, respected, and adequately supported. Could there be a middle ground that encapsulates the merits of both personal engagement and economic viability? And how might the stakeholders in the healthcare ecosystem work collaboratively to explore and manifest such a balance?

At this point, resource management is front and center and to be honest is finally starting to have some real impact for the last several years.

Even a simpleton knows the best care providing company that's out of business provides no care.

As to practice "style" vs diagnostic prowess providing value to patients, let's be honest, the majority of medical visits for medical problems are routine and could be managed perfectly reasonable by ChatGPT, diagnosis - wise. Whereas, a minority of the time, getting the very best opinion is actually going to matter. Most patients understand this concept at some level, thus why when they're scared, they'll tolerate (and even be grateful for) a brusque, gruff, impersonal style if they have confidence in the care plan. Other times they'll raise holy hell because there wasn't enough parking available when they got their flu shot.

[Sculptor1]

It seems to me that over the last few decades doctoring has transformed from a hands on practice to a pill dispensing machine.

There is now a pill for every ill. And Pharma seems to geared to sell pills that keep you going without providing any kind of cure, since there is no money to be had from people who no longer need pills.
Key drugs of this catagory: Statins, PPI, CCIs, Bet Blockers, Diebetes pills such as Metformin. These are drugs given so that people can maintain their unhealthy lifestyles and dietst for keeping their diseases.
This has accompanied a pandemic of Tyoe2Diabetes, Obesity, athersclerosis, heart disease and Alzheimers. - all due can be assicaited with bad diets.

There are moves to return to a more "Functional" approach which seeks to understand the causes of disease, and address the problem with nutrition and supplimentation where necessary.

I can talk about my personal journey of rejecting 4 medications, chaging my eating habits, increasing my exercise and losing 50lbs in weight, but I am prevented from linking to various You tube practicioners,
Here's my readin list.

2023, Van Tulleken, Chris, Ultra Processed People, Penguin.
2020, Taubes, Gary, The Case for Keto, Granta
2010, Taubes, Gary, Why We Get Fat, Anchor
2020, Macciochi, J., Immunity; the science of staying well, Experiment Pub.
2021, Lustig, Robert, Metabolical, Hodder & Stoughton
2013, Lustig, Robert, Fat Chance, Harper Collins.
2021, Specter, Tim, Spoon Fed,Vintage Books.
2021, Chatterje, Rangan, The Four Pillar Plan, Penguin.
2016, Fung, J, The Complete Guide To Fasting, Victory Belt Publishing.
2022 Johnson, Richard, Nature Wants Us to Be Fat, BenBella Books
2014 Perlmutter, Dr David, Grain Brain, Hodder & Stoughton.
2014, Teicholz, Nina, The Big Fat Surprise, Simon & Schuster.
1958,1975 Mackarness, Richard, Eat Fat and Grow Slim, Fontana Collins.

[LuckyR]

It seems to me that over the last few decades doctoring has transformed from a hands on practice to a pill dispensing machine.

There is now a pill for every ill. And Pharma seems to geared to sell pills that keep you going without providing any kind of cure, since there is no money to be had from people who no longer need pills.
Key drugs of this catagory: Statins, PPI, CCIs, Bet Blockers, Diebetes pills such as Metformin. These are drugs given so that people can maintain their unhealthy lifestyles and dietst for keeping their diseases.
This has accompanied a pandemic of Tyoe2Diabetes, Obesity, athersclerosis, heart disease and Alzheimers. - all due can be assicaited with bad diets.

There are moves to return to a more "Functional" approach which seeks to understand the causes of disease, and address the problem with nutrition and supplimentation where necessary.

I can talk about my personal journey of rejecting 4 medications, chaging my eating habits, increasing my exercise and losing 50lbs in weight, but I am prevented from linking to various You tube practicioners,
Here's my readin list.

2023, Van Tulleken, Chris, Ultra Processed People, Penguin.
2020, Taubes, Gary, The Case for Keto, Granta
2010, Taubes, Gary, Why We Get Fat, Anchor
2020, Macciochi, J., Immunity; the science of staying well, Experiment Pub.
2021, Lustig, Robert, Metabolical, Hodder & Stoughton
2013, Lustig, Robert, Fat Chance, Harper Collins.
2021, Specter, Tim, Spoon Fed,Vintage Books.
2021, Chatterje, Rangan, The Four Pillar Plan, Penguin.
2016, Fung, J, The Complete Guide To Fasting, Victory Belt Publishing.
2022 Johnson, Richard, Nature Wants Us to Be Fat, BenBella Books
2014 Perlmutter, Dr David, Grain Brain, Hodder & Stoughton.
2014, Teicholz, Nina, The Big Fat Surprise, Simon & Schuster.
1958,1975 Mackarness, Richard, Eat Fat and Grow Slim, Fontana Collins.

Your post would make generalizable sense if patients routinely took advice and made lifestyle changes when recommended to do so. Alas, lifestyle modification has been the standard of practice (before Big Pharma) and wasn't typically adopted, hence the next best thing, pills, then surgery.

Thus the change in doctor's practice has more to do with patient preference than doctor ignorance/laziness or financial pressure.

[Sculptor1]

It seems to me that over the last few decades doctoring has transformed from a hands on practice to a pill dispensing machine.

There is now a pill for every ill. And Pharma seems to geared to sell pills that keep you going without providing any kind of cure, since there is no money to be had from people who no longer need pills.
Key drugs of this catagory: Statins, PPI, CCIs, Bet Blockers, Diebetes pills such as Metformin. These are drugs given so that people can maintain their unhealthy lifestyles and dietst for keeping their diseases.
This has accompanied a pandemic of Tyoe2Diabetes, Obesity, athersclerosis, heart disease and Alzheimers. - all due can be assicaited with bad diets.

There are moves to return to a more "Functional" approach which seeks to understand the causes of disease, and address the problem with nutrition and supplimentation where necessary.

I can talk about my personal journey of rejecting 4 medications, chaging my eating habits, increasing my exercise and losing 50lbs in weight, but I am prevented from linking to various You tube practicioners,
Here's my readin list.

2023, Van Tulleken, Chris, Ultra Processed People, Penguin.
2020, Taubes, Gary, The Case for Keto, Granta
2010, Taubes, Gary, Why We Get Fat, Anchor
2020, Macciochi, J., Immunity; the science of staying well, Experiment Pub.
2021, Lustig, Robert, Metabolical, Hodder & Stoughton
2013, Lustig, Robert, Fat Chance, Harper Collins.
2021, Specter, Tim, Spoon Fed,Vintage Books.
2021, Chatterje, Rangan, The Four Pillar Plan, Penguin.
2016, Fung, J, The Complete Guide To Fasting, Victory Belt Publishing.
2022 Johnson, Richard, Nature Wants Us to Be Fat, BenBella Books
2014 Perlmutter, Dr David, Grain Brain, Hodder & Stoughton.
2014, Teicholz, Nina, The Big Fat Surprise, Simon & Schuster.
1958,1975 Mackarness, Richard, Eat Fat and Grow Slim, Fontana Collins.

Your post would make generalizable sense if patients routinely took advice and made lifestyle changes when recommended to do so. Alas, lifestyle modification has been the standard of practice (before Big Pharma) and wasn't typically adopted, hence the next best thing, pills, then surgery.

Thus the change in doctor's practice has more to do with patient preference than doctor ignorance/laziness or financial pressure.

I do not think you get to blame the victim so easily. People tend to listen to the experts and on the matter of nutrition the expertise has been wrong.
On the matter of doctoring, the profit motive has moved forwards without any particular awareness of the majority of the populace.

[LuckyR]

It seems to me that over the last few decades doctoring has transformed from a hands on practice to a pill dispensing machine.

There is now a pill for every ill. And Pharma seems to geared to sell pills that keep you going without providing any kind of cure, since there is no money to be had from people who no longer need pills.
Key drugs of this catagory: Statins, PPI, CCIs, Bet Blockers, Diebetes pills such as Metformin. These are drugs given so that people can maintain their unhealthy lifestyles and dietst for keeping their diseases.
This has accompanied a pandemic of Tyoe2Diabetes, Obesity, athersclerosis, heart disease and Alzheimers. - all due can be assicaited with bad diets.

There are moves to return to a more "Functional" approach which seeks to understand the causes of disease, and address the problem with nutrition and supplimentation where necessary.

I can talk about my personal journey of rejecting 4 medications, chaging my eating habits, increasing my exercise and losing 50lbs in weight, but I am prevented from linking to various You tube practicioners,
Here's my readin list.

2023, Van Tulleken, Chris, Ultra Processed People, Penguin.
2020, Taubes, Gary, The Case for Keto, Granta
2010, Taubes, Gary, Why We Get Fat, Anchor
2020, Macciochi, J., Immunity; the science of staying well, Experiment Pub.
2021, Lustig, Robert, Metabolical, Hodder & Stoughton
2013, Lustig, Robert, Fat Chance, Harper Collins.
2021, Specter, Tim, Spoon Fed,Vintage Books.
2021, Chatterje, Rangan, The Four Pillar Plan, Penguin.
2016, Fung, J, The Complete Guide To Fasting, Victory Belt Publishing.
2022 Johnson, Richard, Nature Wants Us to Be Fat, BenBella Books
2014 Perlmutter, Dr David, Grain Brain, Hodder & Stoughton.
2014, Teicholz, Nina, The Big Fat Surprise, Simon & Schuster.
1958,1975 Mackarness, Richard, Eat Fat and Grow Slim, Fontana Collins.

Your post would make generalizable sense if patients routinely took advice and made lifestyle changes when recommended to do so. Alas, lifestyle modification has been the standard of practice (before Big Pharma) and wasn't typically adopted, hence the next best thing, pills, then surgery.

Thus the change in doctor's practice has more to do with patient preference than doctor ignorance/laziness or financial pressure.

I do not think you get to blame the victim so easily. People tend to listen to the experts and on the matter of nutrition the expertise has been wrong.
On the matter of doctoring, the profit motive has moved forwards without any particular awareness of the majority of the populace.

Well, I grant you that your post is accurate as written, yet in no way negates my points. Yes, patients "listen" to their doctor but the follow-through to actually make inconvenient lifestyle changes is dismal in all but the most motivated few percent. As to whether the nutritional advice from doctors is right or wrong, there obviously is an extremely wide range of of advice that has been promoted within and outside of the medical community and while there is not universal consensus even to this day on the optimum strategy, I concede that given how common absolutely terrible eating habits are in the population, that MDs (who have almost no Med School training in weight loss nutrition advice) who don't have a particular interest in the subject likely give advice, that while a lot better than what their patients are currently doing, is not optimal. My point, though is that it's not like patients are following suboptimal advice to the letter, and all they need is better advice. Basically, they're not following such advice longterm in any statistically meaningful amount. Thus pills, then surgery.

As to profit motive, that was relatively a bigger incentive for docs (specifically) during Fee For Service medicine, way, way back before managed care (in the early 80s). Nowadays, equipment manufacturers and Pharmacy corporations are where the profits are, not physician compensation.

[Sculptor1]

It seems to me that over the last few decades doctoring has transformed from a hands on practice to a pill dispensing machine.

There is now a pill for every ill. And Pharma seems to geared to sell pills that keep you going without providing any kind of cure, since there is no money to be had from people who no longer need pills.
Key drugs of this catagory: Statins, PPI, CCIs, Bet Blockers, Diebetes pills such as Metformin. These are drugs given so that people can maintain their unhealthy lifestyles and dietst for keeping their diseases.
This has accompanied a pandemic of Tyoe2Diabetes, Obesity, athersclerosis, heart disease and Alzheimers. - all due can be assicaited with bad diets.

There are moves to return to a more "Functional" approach which seeks to understand the causes of disease, and address the problem with nutrition and supplimentation where necessary.

I can talk about my personal journey of rejecting 4 medications, chaging my eating habits, increasing my exercise and losing 50lbs in weight, but I am prevented from linking to various You tube practicioners,
Here's my readin list.

2023, Van Tulleken, Chris, Ultra Processed People, Penguin.
2020, Taubes, Gary, The Case for Keto, Granta
2010, Taubes, Gary, Why We Get Fat, Anchor
2020, Macciochi, J., Immunity; the science of staying well, Experiment Pub.
2021, Lustig, Robert, Metabolical, Hodder & Stoughton
2013, Lustig, Robert, Fat Chance, Harper Collins.
2021, Specter, Tim, Spoon Fed,Vintage Books.
2021, Chatterje, Rangan, The Four Pillar Plan, Penguin.
2016, Fung, J, The Complete Guide To Fasting, Victory Belt Publishing.
2022 Johnson, Richard, Nature Wants Us to Be Fat, BenBella Books
2014 Perlmutter, Dr David, Grain Brain, Hodder & Stoughton.
[*]2014, Teicholz, Nina, The Big Fat Surprise, Simon & Schuster.
1958,1975 Mackarness, Richard, Eat Fat and Grow Slim, Fontana Collins.

Your post would make generalizable sense if patients routinely took advice and made lifestyle changes when recommended to do so. Alas, lifestyle modification has been the standard of practice (before Big Pharma) and wasn't typically adopted, hence the next best thing, pills, then surgery.

Thus the change in doctor's practice has more to do with patient preference than doctor ignorance/laziness or financial pressure.

I do not think you get to blame the victim so easily. People tend to listen to the experts and on the matter of nutrition the expertise has been wrong.
On the matter of doctoring, the profit motive has moved forwards without any particular awareness of the majority of the populace.

Well, I grant you that your post is accurate as written, yet in no way negates my points. Yes, patients "listen" to their doctor but the follow-through to actually make inconvenient lifestyle changes is dismal in all but the most motivated few percent. As to whether the nutritional advice from doctors is right or wrong, there obviously is an extremely wide range of of advice that has been promoted within and outside of the medical community and while there is not universal consensus even to this day on the optimum strategy, I concede that given how common absolutely terrible eating habits are in the population, that MDs (who have almost no Med School training in weight loss nutrition advice) who don't have a particular interest in the subject likely give advice, that while a lot better than what their patients are currently doing, is not optimal. My point, though is that it's not like patients are following suboptimal advice to the letter, and all they need is better advice. Basically, they're not following such advice longterm in any statistically meaningful amount. Thus pills, then surgery.

As to profit motive, that was relatively a bigger incentive for docs (specifically) during Fee For Service medicine, way, way back before managed care (in the early 80s). Nowadays, equipment manufacturers and Pharmacy corporations are where the profits are, not physician compensation.

Perhaps you might be interested to read Teicholz. She is a reformed vegetarian and journalist who went on a journey to find out more about fat.
People HAVE taken advice and the consumption of meat and dairy has dropped in favour of more vegetable products. THe food industry has responded by lowering fact in pre-prepared meals an replacing the calories with carbs. People eat less lard, less butter, fewer eggs. but more grains and carb rich foods.
Result: obesity, T2D, insulin resistance, leptin resistance.

[Sushan]

It doesn't matter. There has been and there will always be a spectrum of patient tendancies. Some will go along with the doctor's opinion 100% and some 0% and every number in between. Trust me, healthcare providers have seen all types before, there is nothing you're going to question (second guess) or pull off of some website that they haven't heard (and dealt with) before.

It is silly to think that a doctor could change how individual patients handle information. It is equally silly to suppose that a patient armed with a book is going to fundamentally change how a professional manages their practice.

As to the second question, classic example of a false duality.

Your response brings a pragmatic lens to the discussion, underscoring the vast array of patient tendencies and the seasoned experience of healthcare professionals in navigating these. It's a reminder of the deeply ingrained human behaviors and the complex dynamics at play in the patient-provider relationship.

You also highlighted a compelling point regarding the purported dichotomy between a more personal approach to medicine and a business-oriented model. It insinuates a richer landscape of possibilities that could potentially harmonize the values of care, trust, and financial sustainability.

It stirs a reflection on the potential pathways to foster a healthcare environment where both patients and providers feel understood, respected, and adequately supported. Could there be a middle ground that encapsulates the merits of both personal engagement and economic viability? And how might the stakeholders in the healthcare ecosystem work collaboratively to explore and manifest such a balance?

At this point, resource management is front and center and to be honest is finally starting to have some real impact for the last several years.

Even a simpleton knows the best care providing company that's out of business provides no care.

As to practice "style" vs diagnostic prowess providing value to patients, let's be honest, the majority of medical visits for medical problems are routine and could be managed perfectly reasonable by ChatGPT, diagnosis - wise. Whereas, a minority of the time, getting the very best opinion is actually going to matter. Most patients understand this concept at some level, thus why when they're scared, they'll tolerate (and even be grateful for) a brusque, gruff, impersonal style if they have confidence in the care plan. Other times they'll raise holy hell because there wasn't enough parking available when they got their flu shot.

Your perspective on resource management and the varying expectations of patients in healthcare is quite thought-provoking. It reflects the practical challenges and realities of modern healthcare systems, where the balance between providing quality care and managing resources efficiently is a constant struggle.

The point you raised about the routine nature of most medical visits is significant. It suggests that a large portion of healthcare delivery could be streamlined or even automated, freeing up resources and attention for cases where specialized, expert care is crucial. This approach could potentially optimize the healthcare system, ensuring that resources are allocated more effectively.

However, your observation about patient expectations also sheds light on the human aspect of healthcare. Patients' perceptions of care quality are not solely dependent on the medical outcome. Factors like communication, empathy, and even logistical aspects like parking facilities play a role in their overall experience. This underscores the complexity of healthcare delivery, where both the technical and human elements are crucial.

Considering these points, how do you envision the future of healthcare, where technological advancements like AI could handle routine medical inquiries, while human practitioners focus on more complex cases? Also, how might healthcare systems evolve to better address the diverse and sometimes contrasting expectations of patients, ensuring both efficient care delivery and patient satisfaction?