| "SELECTED QUOTES FROM STUDENTS ATTENDING CLASSES TAUGHT BY PROFESSOR TOR DAHL" |
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Quotes
from Students Papers
2000 |
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“I see no reason or need for my doctor to love me nor would I expect him to suffer with me. I wouldn’t demand a lot of my doctor’s time. I just wish he would brood on my situation for perhaps five minutes, that he would give me his whole mind just once, be bonded with me for a brief space, survey my soul as well as my flesh, to get at my illness, for each man is ill in his own way” (Anatole Broyard). Dr. Francis Sellers Collins, medical geneticist, directs the National Human Genome Research Institute, a part of NIH. He predicts that:
— Joyce Wood, Is Health Possible Without Healing? ----------------------- Managed care will always have a place for the patient who will endorse jumping through the hoops in cattle care. — Patricia E. Arola, Economics of Managed Dentistry ----------------------- Eighty percent of all workers’ compensation claims result from stress or trauma in employees’ work lives or personal lives. — Ben Koppelman, Employees Wellness Programs: Not Just Another Fad ----------------------- The technological components of an intensive care unit are objects of entitlement because they exist, not because they are always beneficial. . . . In the old days, life was over when the heart stopped beating. That was the last time to say goodbye and pull a sheet over the body. But these days, cardiac arrest often marks the start of a frenzied dance. Nurses call out, doctors come running. They leap upon the body with their last bit of magic—breaking ribs, dispensing electric shocks, forcing a tube down a quiet throat. Sociologists view rituals as “role activities that are far more focused on processes or protocols than on consideration of likely outcomes.” “ICUs were intended to be only temporary havens for desperately ill patients who would be expected either to die or recover. But, today, ICUs have become a kind of purgatory for many patients who remain for months and months on the brink of death.” —Nancy Dimunation, Medical Futility—Issues Surrounding Care at the End of Life ----------------------- A 1990 study by the American Medical Association found that a substantial portion (31%) of young physicians (those under 40 who had been in practice for 1-7 years), given what they now knew, would not have gone to medical school. Another 9% of the study group physicians were unsure as to whether or not they would now choose medicine as a career. To hear physicians tell it, their lives have been utterly ruined by the rise of managed care. Longer office hours, smaller incomes. Paperwork mushrooming out of control, non-physicians second-guessing and overriding around every corner, and relationships with patients going down the tubes. [Satisfied physicians] enjoyed intellectual stimulation, good income, interactions with patients, outside interests, and ability to teach others. . . . [M]ore satisfied doctors have put balance in their lives by being married, having a hobby, and /or allowing for more leisure time. — Allen E. Patterson, Factors Affecting the Satisfaction of Physicians ----------------------- In the report titled “To Err is Human: Building a Safer Health System,” The Institute of Medicine cited studies that indicated medical errors kill 44,000 to 98,000 people in the United Sates every year. . . . [C]onsidering the lower estimate done, that figure would eclipse deaths from other sources in the nation, including breast cancer, AIDS or motor vehicle accidents. . . . Based on this extrapolation, chances of being injured increase approximately 6% for each day of hospitalization. This means that during a three-day hospital stay, the odds are nearly one in five that some caregiver will make a mistake that hurts the patient. — Karon A. Lyon, Patient Safety—More than Doing the Right Thing ----------------------- If one takes the old saw that something like 80% of patients in a physician’s office do not need to be there, it will take huge samples to demonstrate actual differences in outcomes as a result of care provided by various types of individuals. There is very little documentation of the comparability of care by non-physician clinicians with that provided by physicians. I remember several years ago hearing our neighbor describe how she needed to return from vacation because she was found to have high [blood?] pressure after passing out somewhere in the Western United States. She told me strange things were happening as well—she had begun to grow hair over much of her body. When she called her health maintenance organization for an appointment and spoke with a non-physician provider, she was given a timeslot six or seven weeks later. To anyone trained in medicine, her complaints could only have been an adrenal tumor, and any physician would know that these are highly malignant and need immediate therapy. — Kent Crossley,Prognostication is Perilous:Why Can’t We Predict Physician Workforce Needs?----------------------- Consumers are bypassing both the health care delivery system and health insurance systems to seek the information they need to frame their interaction with both systems. Ultimately, this will result in a consumer driven healthcare system, replacing the traditional provider driven one. As a result, healthcare providers are being forced to rethink their traditional roles in care delivery. — Bonnie L. Briggle, “Transforming Health Care via the Internet” ----------------------- Health care consumers are taking things into their own hands; the industry will be revolutionized by the power of the consumer. The most pervasive change in the new millennium is the technological empowerment of patients to take control of their own health care. The providers of health care need to be ready and willing to cater to consumers or get out of their way. The Internet will cause a massive “disintermedication” or elimination of the middleman in favor of the consumer. The Internet is the poster child of the “Knowledge Society.” It blows wide-open the medical system’s monopoly on medical knowledge. American International Group, Inc. (AIG) will offer their insurance policy holders a second medical opinion, via the Internet, in 16 foreign countries. This is a boost for telemedicine in expanding the number of telemedical exams. Medical histories, tests, x-rays and other scans will be digitized and sent to a hospital who sends on to a provider. This policy enhancement will allow clients in other countries an option to access the world’s best doctors. — Patricia Brahe; The Uses of the Internet for Health Care; Adding Care to Content, Connectivity and Commerce: It’s Possible through Collaboration ----------------------- According to Cisco Systems, Inc., the Internet is being adopted faster than any previous communications technology. It has surpassed radio (38 years), the personal computer (16 years), and TV (13 years) by reaching 50 million users in only four years. — Jason T. Douglas, How Bandwidth (Storewidth) is Changing Healthcare ----------------------- Mental health and substance abuse disorders currently affect about one quarter of all adults between 18 and 64. Mental illnesses are more common in our society than cancer, diabetes and heart disease. Managing outcomes (in behavioral health) is much more efficient than the micro-management of processes.” One day, consumers operating through corporate buying groups will be aggregated on regional business-to-business sites to buy services from groups of doctors and hospitals negotiating on the basis of price, credentials and quality ratings. Coverages can be customized across different plans,…consumer ratings of different doctors and other key data will be at the fingertips of the newly empowered consumers on other websites. Everyone, whether patient, doctor or hospital, will make out by splitting up that 20% or so of the health system’s cost that today is eaten up by managed care. — Abby L. Wasserman, Managed Behavioral Health Care: Boon or Boondoggle? ----------------------- The more physician participation in home care, the better the quality of care and the access to care. The service most likely to result in a change in performance from hospital to home was the provision of physician house calls, in which case 24% of those initially preferring the hospital would prefer care in the home. — GerriAnne Huey-Graham, House Calls: Can We Paint a Rockwellian Picture? ----------------------- Philanthropy is often dismissed, ignored or treated as an afterthought of the merger process…. Convincing the public to give money for new hospital construction is a tougher sell today because institutional loyalty has all but ceased to exist, thanks in part to managed care… And just as the focus of health care is shifting away from inpatient hospitalizations, so, too, are the aims of health care philanthropy. Today’s successful fundraising campaigns now focus on generating needed capital for developing and funding specific health programs to improve community health status, . . . Americans have always generously supported their community hospitals: last year they gave $1.92 billion in cash and total gifts of nearly $3.4 billion. With health services, the consumer and provider (if not under risk sharing contracts) have incentive for service utilization, but the payer does not. — Beth K. Plahn, Pediatric Populations with Chronic Health Service Needs: Alternatives of Organizations of Beneficial and Cost-Effective Financing and Delivery Systems ----------------------- Of the approximately 300,000 individuals suffering hip fractures each year, 20% die, 25% are confined to long-term facilities, and 50% retain a long-term loss of mobility. Additionally, psychological symptoms, such as depression, may present as patients struggle to deal with pain, physical limitations, and lifestyle changes they experience due to limitations forced by a hip fracture. . . . Up to 85% of the population variance in bone mineral density is considered to be genetically determined…the totally preventable disease of osteoporosis and its debilitating complications can be eliminated entirely. — Jayme Heim-Beron, Osteoporosis: Prevention and Treatment ----------------------- [Pharmacy costs] have become an expense that is increasingly hard to swallow. There appears to be a phenomenon occurring where diseases are “created.” Treatment is now offered for situations that were not previously considered disease states, such as toenail fungus. There is an epidemic of toenail fungus print and direct-to-consumer advertising. An inexpensive drug that is not needed or that treats a trivial condition adds to health spending, whereas a very expensive drug that prevents a costly disease could be a bargain. —Gerri Burmeister, Pharmacy Costs and the Impact on Health Insurance Charges ----------------------- Direct-to-consumer advertising may cultivate the belief among the public that there is a pill for every ill and contribute to the medicalization of trivial ailments, leading to an even more “overmedicated” society. An inexpensive drug that is not needed or that treats a trivial condition adds to health spending, whereas a very expensive drug that prevents a costly disease could be a bargain. The great unknown is whether direct-to-consumer advertising will create enough demanding patients that more than a few physicians will prescribe drugs against their better judgement. The cost will be measured not only in lower quality of prescribing, but also in reduced professionalism, impaired physician morale, and possibly even a sea change in the type of student who is attracted to medicine. — Barbara E. Tauscher, The Economic Impact of Direct-to-Consumer Advertising of Prescription Drugs ----------------------- Cardiovascular deaths are now less than half of what they were three decades ago. — Jeffery F. Peipert,Economic Evaluation of Medical Research:Benefit and Opportunities----------------------- It has been estimated that one in four individuals has had a close experience with mental illness, involving a family member or close friend. . . . Estimates of costs of mental health services have been as high as one-fourth of all dollars spent on health services in the United States. — David Lawlor,Towards Performance in Public Mental Health Systems----------------------- It is difficult to believe [that there is equal access to health care in Canada] when sports figures or politicians can jump the queue and receive medical care before people who have been on the waiting list for months. — Linda Hamilton,The Canadian System—Reform or Privatization?----------------------- Two recurring problems in the delivery of healthcare, a shortage of nurses and the avoidance of family practice by MDs, could be solved over the next 5-10 years by replacing all family practitioners by nurse practitioners. — Richelle Jader,Nursing Shortages Family Practice:A Modest Proposal----------------------- |
Copyright © 2007 Tor Dahl & Associates