Are we all "medical citizens," embedded as a potential or actual patients, our physicians, insurance & # 39; and pharmaceutical companies, government agencies, and others in the system of social, moral and organizational stakeholders?
Today, with the advent of the Internet, high-speed bandwidth, Social Media, Support Groups and Self Care protocols, patients for the first time in the history of medicine are able to change the result of the disease and the illness themselves, family members, friends and significant others .
This study attempts to address the most compelling issue of our time. Medical self-help groups and self-care methods are useful, and they deny that the delivery of conventional medical treatment? How do they differ and what consequences arise from this debate?
Further, it has been the advent of the Internet and social media has changed the landscape of medicine? What limitations may exist in this new era of information technology and social communication? And if so, to what extent it would challenge the traditional care models? Perhaps the patient or advocate increasing the expert's own health conditions than their own doctor? The answer to this question is a definite yes if the patient has to use all the tools available to them.
Various published estimates unanimously show that hundreds of thousands of patients die, and millions of people were injured in medical procedures gone wrong, medication errors or adverse events and medication incorrectly prescribed or not taken as directed by patients. And it's not just the sick, the suffering, but the families that loved one & # 39; s, friends and employers & # 39; s who have to suffer the pain and lifestyle changes that so often comes with these errors.
Furthermore, May 8, 2013 National Center for Policy Analysis, edition, claimed that the first diagnosis of the error rate is increasing at an alarming rate
• An estimated 10 per cent to 20 per cent of cases false diagnosis that exceeds the drug errors, and surgery in the wrong patient or body part, each will receive much more attention.
• A report said 28 percent of 583 diagnostic errors were life-threatening and resulted in the death or disability.
• Another study estimated that the fatal diagnostic errors equals the number of US intensive care units breast cancer deaths per year – 40500th
Therefore, the second opinion is often necessary precautions that third opinion if the first two apart. In fact, Medicare and insurance companies often pay a third reviews under these conditions, since they will save billions in the long run.
Prudence dictates that the "medical nationals" should beware of these pitfalls, as their lives depend on it.
Furthermore, patient reviews and rating systems are available directly from your smart phone, you need to determine whether or not the doctor's decision-making is compromised. For example, the surgeon knows that his treatment decisions may even result in either saving a life means to an end of the social media prejudices, whether legitimate or not, then what hurts medical practice? Does it distort that could alter cloud or a doctor & # 39; s judgment? There are no data to provide an answer as yet.
So, doctors are becoming more risk adverse as a result of the new landscape? Now doctors are compensated based on getting better results, lower costs, reduced re-admission rates and other variables – not the staff friendly and less time in which many doctors waiting room review sites measure.
Often five-star rating system will receive some patients' opinion, despite the fact that the average doctor has some 2,000 patients charts (most healthy), and as long as human nature to complain if we do not get the result we want, consumers are less likely to praise the positive experience because I naturally expect top service, and so neglect to post a positive review even more patients are more likely to post a negative review of retaliation against the provider. Thus, the patient's opinion is not very good, or objective source of fair and balanced overall assessment of a doctor & # 39; s performance.
How can this dilemma be solved, especially if the surgeon everything perfectly, but the patients are victims of medication errors, poor care complying with the medical order, or perhaps agreements in hospital born infections or other adverse events among the doctor & # 39; s control, even if the doctor & # 39; s excellent work? However, these doctors often blame the doctor review sites. Therefore, patients should be better tools to make your own health care decisions should be in, choosing a plan or what treatment option to go to a specific facility.
If the patient does not use a rating site, you must make sure that from the government side a huge amount of data or in a private place, where doctors may nominate other doctors for excellence, and use these "Dr. & # 39; s doctors "to care for their friends and loved ones.
doctor believes that other sites can help you stupid criteria such as waiting room times, friendly staff, waiting room decorations and other issues that have nothing to do with the best results are nothing, but to money from the players.
Today, it is not unusual for patients to challenge doctors when it comes to illness and disease. After all, according Tejal Gandhi, MD, president of the National Patient Safety Foundation and associate professor of medicine, Harvard Medical School, "preventable medical errors persist, the No. 3 killer in the United States – the third only to heart disease and cancer – claiming the lives of about 400,000 people a year at a cost of more than a trillion dollars a year. ' "
Self-help groups and self-care is probably date back to the dawn of civilization, when people lived in a cooperative tribal settings. These groups deal with issues related to all life survival and political stability of the group. the dawn of medical ethics is probably dates back some 2300 years of the publication of the Hippocratic oath.
But now the game has dramatically changed due to the significant technological advances in medical science and the great development of the Internet is now the primary medical information for medical consumers. and the explosion of social media, people are able to communicate and share information on a scale never seen or imagined.
Add this to all the new interest that have entered the fray, such as insurance, employers, managed care organizations, Obamacare, biotech companies, governments, of course, pharmaceutical companies and health care decision-makers. The challenges faced by medical and social planners citizens have never been so terrifying.
Postmodern Medicine Medicare probably generated by the institution in 1965, when Medicare was signed into law in 1965 by President Lyndon Johnson and paid by the third party insurers appeared soon after. The 1970 & # 39; s medical practice has been in the business of medical surge and third-party payment systems caused by the demand for services and the cost of health care delivery soared. Moreover, the debate must be about the disease and what the disease is now to deal with sociological way more than ever, it affects whether treatments are available, and what the costs of third-party payers.
Self help groups are usually a group or set of people who suffer all shares or a similar disease that involves high costs and personal suffering to themselves and those who care about them.
Self-Reliance seemingly obvious meaning. We get a cut and put a band aid on it. A headache to an aspirin. But is it really so clear as pharmacy shelves already full will to drugs that previously only available with a prescription and medical devices can be used for self-diagnosis and self-care that measures bodily functions and vital signs such as blood sugar, blood pressure, pulse rate, oxygenation, etc. resulted in the patients self-diagnosing and treating themselves, often without medical advice. Defibrillators now a fixture in most large organizations, where non-designated medical company personnel trained and licensed to shock a worker & # 39; In addition to CPR and heart.
supplies, such as instant clotting powder, special bandages, compression diabetic socks that were not previously available in pharmacies that are now commonplace. But many of these products as much harm as good, if not used properly.
Self-care, at least in several versions usually include some kind of relationship with the health system, teaching people, when you need a professional, how to do a self-examination without medical supervision and care conditions. eg changing bandages wound dressings without the presence of home care support.
And with the advent of drugs, televisions approved by the new and off-label use of FDA awash with advertisements in the advertising of new drugs and therapies that embrace the incredible benefits than Viagra, resulting in panic he runs for patients doctors are demanding a bucket of things that Viagra is one of the most profitable drugs ever be selected.
Television advertisements for pharmaceutical companies now target the consumer directly to the demand for their products, which are only prescribed by a physician, are common as well. In addition, the small print and strangled high-speed speech, pharmaceutical companies attempt these ads, it is not responsible for the drugs advertised directly to consumers can have side effects that can seriously mess of a person, or even can cause death, while at the same time consumers are trying to ask the doctors of these medicines. This radical change in the supply chain and marketing of new pharmaceutical products and protocols.
So, what do the medical nationality? Turn to the Internet, of course, the Information and Social Media discourse. After all, the Internet is now the primary source of health and medical information and social communication.
Today, more than one hundred million Americans & # 39; s online computers, tablets, mobile phones, watches and smart to find applications with highly specialized support, such as a menu in a Greek restaurant. If it is difficult to choose wisely.
The problem is consuming a useful and credible information garbage in, garbage out, or commercial sites wanting to sell goods and services to each user searches performed on target transmitted by users, advertisers cookies and Flash Player LSO k.
Most people are probably not OK, and there is no doubt responsible for using this resource. and perhaps develop an extension of the patient & # 39 These resources; s life and allows them to find the other communities & # 39; and suffering from the same disease as they are, and provide assistance in health outcomes and help contain health care costs for society. Getting started with virtualization, telemedicine, medical and hospital assessment web pages and long-distance robotic surgery, and even areas such as quantum medicine, which seems as if it comes straight out of a science fiction novel.
Should this lead us in the future remains to be seen, and not finally addressed in this essay.
This leaves us with the question in dispute disease. By contrast, the disease is like a clogged artery must be repaired with a stent in a catheterization laboratory, an interventional cardiologist or an infection that must be treated with antibiotics by a doctor, many diseases are unexplainable by conventional medicine as opposed to the disease clearly recognized healthcare providers. Diseases often simply dismissed the official medicine such denial or refusal of insurers to pay for treatment. a description of the occurrence of
But the same collective array of symptoms similar to those of thousands of people to communicate with one another using self-help groups can lead to a change of heart in the medical establishment. Not to mention that diseases with a social stigma with them, where the patient is blamed for their symptoms, such as obesity, despite the fact that cause diseases obesity, depression, addiction, and numerous diseases has not yet been classified in the disease and for which there is a biomedical solution .
groups are also online support, and have those terms in the lead, as in the case of fibromyalgia, which has as a curable disease, but for a long time was today attacked by disease declined professionals, as people too lazy to work, or just looking for painkillers. What is certain is that online support groups for people the opportunity to exchange information with each other and become an expert medical problems.
free online self-help groups and very effective. People Helping People. It's a simple concept, especially in an era when the nuclear family almost extinct in Western society that people are now looking for a large family. But self-help groups, which are independent and autonomous in theory, is still susceptible to the traditional collective problems such as competition within the groups, the non-compliant members, etc. They are also the target of commercial interests, for example, when a user who does not know how to surf anonymously receive hundreds cookies on the device they are using, and then begin to befoghat ads by commercial interests, or worse, spam and theft of personal information.
Self help groups offer other benefits, such as "clearer cope with chronic illness and life transitions, friendship and belonging, spiritual renewal, increased political activism, strengthening civil society and reduced Healthcare Resource Use" (Humphreys, Keith , social Policy, Spring 97, vol 27, Issue 3 Pages 2-5)
True, the "social movements see themselves as omnipotent and omniscient are often dangerous." (Humphreys, Keith, Social Policy, Spring 97, Vol 27, Issue 3 Page 5)
You can take a horse to water, but can not drink it. Many people are judgmental and rear set too intent in ways that may damage or disrupt the best of intentions, among many others.
Many medical professionals feel that patients play doctor carries potentially serious risks, since the patient is not a doctor or a qualified health care professionals. On the other hand, many people say the same experts and professional groups that have previously enjoyed unquestioned stature and in many cases offense being questioned or challenged.
But a patient is a complex disease possibly other accompanying diseases Internet gives them unlimited access to the latest research, medical treatment, medicines and many other research, the physician may not be aware of.
Difficult patient loads the doctor does not have time to spend researching medical literature of all worlds FDA new drugs and procedures. After the doctor sees the patient, they often do not give that person & # 39; s situation is another thought, as they further 30 patients to see that day plus hospital rounds.
But if a patient is in relatively good intelligence, and probably they have much more time to research the specific disease or diseases that ravaged their quality or life, ability to work or career development, relationships with suffering, it is a logical assumption that enough time and persistence, patients find the right treatment options, or the right of doctors to relieve most of the symptoms or possibly cure them completely.
If the patient remains obedient, do not ask questions, does not review or complex medical bills inspectors did not understand the billing codes, then the patient probably will not get the best possible results.
This issue has been thoroughly researched by the Institute of Medicine, and the data show that resoundingly informed patients consistently improved medical outcomes than those that suffer in silence. The data is irrefutable!
Therefore, common sense dictates that patients are proactive and learn as much as possible about serious diseases and work with physicians as a team, the goal is to get better medical care. Doctors often resist change, in which case the doctor may be in the interest of the patient.
mortality example related to cardiac catheterization and angiography are significant enough that patients should be aware of the risks of death or serious complications of the procedure, or that there is an alternative known as computed tomography angiography, which can replace half according to conventional coronary angiography in patients the cost of the traditional method, which is very lucrative as computed tomography angiography intervention cardiologists do. It is also a non-invasive procedure, which is preferred by the holder is much less risk and is also lower cost.
I'm speaking from personal experience because my own father passed away was generated after January 26, 2006, suffered from complications of cardiac catheterization and angiography procedure is unnecessary. The year before my father & # 39; he was passing a stent placed in his left descending coronary artery, which went flawlessly. Since my father retired and living in NY before he goes out to all the doctors, the annual trip to Florida where he spent the winter in the sun.
This method was chosen because the cardiologist suggested that inspected the ride before the stent. I should have known better, and stopped him, because I was the patient and the health care consumer advocacy and researched and published reports by consumers and health professionals researched diseases for a living. The name was the time of my company, "Health Reports" feature Multi Media Solutions Inc. NY company founded disability but later had to stop.
I accompanied my father to all of his doctor visits and when he went to the hospital for an outpatient procedure that was good, and he was driving his own car to the hospital in preparation to go home the same day.
The intervention cardiologist to do the procedure later said the stent was nice condition, but something went wrong, because after the intervention of my fathers limbs began turning blue cyanosis. The doctor, of course, denied that the relationship between the two events occurred within hours of each other.
The only possible conclusion I could draw was that the catheter chipped a piece of calcified plaque and submitted probably in his lungs as a emboli, as developed severe respiratory distress immediately after the angiogram. Now that was to be the largest ever accidental or a terrible medical error.
So routine preventive screening, where I'm going to drive my father's home that became a hospital one week after which it moved to step down rehabilitation facility and was expected to recover, and go home.
should have been the night to go home to continue his recovery at home, I visited with my daughter, and immediately saw that there was something bad.
Since there is only one doctor on the floor about 50 adult residents, I practically had to physically pull the doctor's room, where the only suggestion was that he go back to the hospital. He comes to the rescue 30 minutes to Hime is a major trauma hospital was literally just a few hundred meters from where he was. I had wheeled her to the ER faster.
died around 2:00 the next morning. They said he died of mesothelioma. I knew that was impossible, because I never heard a man coughing once in their life, or present symptoms of mesothelioma and I've been in the business for years with her and her son.
Then, recently, when he was hospitalized with a Florida hospital severely low potassium, which can easily be remedied by a few days of IV potassium infusion, cardiologist walked into the room and said he wanted to do an angiogram just before the discharge to check the stent to a year before I did, and I knew I was okay, and it was close the argument, because it questioned the authority. Finally, he acknowledged that the risk of death or complications during cardiac cateterization was not insignificant. Finally, he agreed to a non-invasive cardiac ultrasound, which showed nothing wrong. Why
And it was not a relationship I'm still in the hospital. He was released the same day, and when I saw the regular cardiologist in New York, called the name of another doctor rather not repeat, and said he might have saved his own life by challenging the man who had never seen before or since.
The thing is I only know because I am an experienced Medical Literature Research but it is blocked.
Because too often, patients are not informed of other treatment options you will ever wrong, or for that matter, the risks associated with possible variety of methods, because doctors simply are not aware of or do not care or want to make the most money. Today, hiring an expert to research the medical literature is not a bad idea. And even a single patient's Advocate is a growing area which is not a professional qualification required is a good idea if you can afford it, because once the flat on your back and not on the control and may not even be a family with the help of personal patient's Advocate can a good idea.
This is the new reality of health. It's hard to be a practicing physician these days because the degree of innovation, problems that regulators a businessman engaged in that hospital patients, litigation, etc. Many doctors & # 39; It can not handle, and quit drugs. And more and more difficult.
Common sense also dictates that there is no longer a monopoly of medical information in this new era of instant information and mass communication and transparency, as the revolution is a good thing once in a while.
Ultimately, as this essay tries to manage or non-medical self-help groups and self-care alternatives for positive materials or harmful challenges of medical care and how to set against each other, and that the consequences of such an analysis, it is concluded with absolute certainty that the polio vaccine, which resulted in a tsunami consists of medical advances since its release to help doctors cure the disease, and now a new, ever-changing era of unprecedented progress in medical science, information and transparent social communication.
The cost of medical research and care as a result of these advances have skyrocketed to the point that the medical resources that can be used to more cost-effective manner. Furthermore, the issue of rationing medical care is one of the social policy makers should be given great weight in its deliberations next year, since the implementation of the Affordable Care Act.
The questions are so complex that consumers choices in a very difficult period, to how best to care for themselves and their families. Just picking a health plan can be a nightmare for families and professionals in a variety of designs can work with families in a variety of prices & # 39; Depending on the benefit or detriment of the socio-economic status, medical history and lifestyle.
If these improvements are not enough to contend with, the current power of the Internet as a source of both information and now also a strong social environment in which people can interact with each other to be seen in the mass as a benefit in a system that you need for the checks and balances of registration, many stakeholders, many of whom lack the patients & # 39; s best heart, but also motivated by greed or simply incompetent profession.
Self help groups are becoming self-sufficient in a patient or a loved one, or an attorney is involved in the management of disease and illness to work dynamically and in collaboration with their doctor, including new medical landscape since the genie has escaped of the bottle, and we do not look back, but you have to expect that a system for patients and caregivers working in a team shoots the healing process and improve the quality of life of citizens.
So what the future holds. The last 30 years have seen an evolutionary leap more than likely see a century or more. Now with new technologies such as 3-D printing and copying, and computer-aided manufacturing and new medical areas such as the principles of quantum physics that uses quantum medicine to better understand the biology of future opportunities mind boggling. The civil war only 152 years ago. Since then, mankind has developed a way of life that sustained civilization some 200,000 years astronomical rate. We can accommodate so many changes so quickly?
Gene Roddenberry foresaw the future beginning in 2236, 220 years later with the release of Star Trek, which is an autonomous steady movement. So what is our fate, or perhaps the prospect of Gene Roddenberry James Cameron & # 39; and "Terminator," where mankind spark an extinction-level event of accidental or terrorism. Only time and the man & # 39; and ingenuity will tell.
Stuart J. Goltzman January 2, 2016 22:40 Eastern Time
Copyright, reproduction is allowed without any changes.
(Humphreys, Keith, Social Policy, Spring 97, Vol 27 Issue3 Pages 2-5)
(Humphreys, Keith, social Policy, Spring 97, Vol 27, Issue 3 Page 5)