Word: patient
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Dates: during 1980-1989
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...results may be mixed. Patients relinquish much of their freedom to choose who will treat them, and can be lost in a shuffle between rotating doctors. The physicians, meanwhile, are transformed from professionals into employees, with a duty to serve not only the interests of their patients but the demands of the corporation as well. "They're asking physicians to pay for their decisions," says internist Madeleine Neems in Lake Bluff, Ill. "That's a terrible concept. When you analyze whether or not a patient needs an expensive test, a lot of times it's not a clear...
Doctors resent spending extra time with patients who demand exhaustive explanations or who merely exercise their hypochondria. "If you have to spend twice as much time because a patient's assertive and he wants to ask questions, it's certainly difficult to bill for that period of time," says cardiologist Alexander. "Lawyers and accountants don't have third parties or government agencies looking over their shoulders to determine whether their billings are fair." Patients understandably take a spare-no-expense attitude toward their health, but that is not a philosophy likely to keep a medical company in the black...
Physicians and patients who are not part of an HMO have found their lives affected too. The government (as the largest health insurer) and the private insurance companies have tried to cap medical costs by deciding in advance how much a particular treatment should cost and balking at anything above that amount. Many doctors can no longer decide how often they see a patient, when one can be hospitalized, or even what drugs may be prescribed. Those decisions are now in the hands of third parties, hands that have never touched the patient directly...
...Other patients are shopping not for savings but for status. This inspires physicians to spend valuable time on self-promotion and merchandising, not skills that contribute materially to patient care. "My feeling was that if you're a decent physician giving decent service, that's really all you should have to do," says Florida ophthalmologist Robert Rogers, who has hired a business consultant to help manage his practice. "But patients don't seem to want that. They like the flashy stuff. They like to see your name in print. They like to see you lecturing...
...effort to be educated consumers, today's patients read books with titles like What Your Doctor Didn't Learn in Medical School and Take This Book to the Hospital with You. The message is that a smart patient is an informed patient, who challenges a doctor's authority rather than submits uncritically to the physician's will and whims. Yet that approach rubs raw against a basic instinct. Patients want to trust their doctors, to view them as benign and authoritative. Even those who privately question a doctor's decisions may be loath to express dissent. Doctors admit that...