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Patient Driven Medicine

by Joel

A paradigm shift in thinking about medicine is necessary to make it safer, more effective and more affordable. Medicine won't protect patients until patients know when they don'tWe cannot "fix" medicine, but we can change the world around it so that it will have to fix itself, and so that patients will be able to avoid the problems when it doesn't.

Most of this site covers the problems. The rest is about solutions. I wish that solutions were the only thing posted here, but gaining insight does not require merely discovering new thoughts. It also requires overcoming old ones. We are drowning in old ones.

Solutions ..........|.......... Problems
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......................... | ............ Myth #1
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Patient Agency... | .........................
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Nequamitis ....... | ........................
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......................... | Conflict/Interest
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........................ | ............. Loyalty
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......................... | ..Wall of Silence
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.................. ...... | .......Blacklisting
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........................ | ....Psych of Care
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........................ | ... Transparency
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........................ | .. Charles Cullen
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........................ | Orville L Majors
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........................ | ......... Kayshyap
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........................ | .............. OSMB
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........................ | ..... Semmelweis
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........................ | . Benjamin Rush
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Patients Boards. | ........................
|
Campaign ... | ..................

"If we can get just 10% of people to be smart patients, it will change the system." - Mehmet Oz, surgery professor.

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Patient Driven Medicine Versus
The Benevolent Overlord Model

Put ten doctors in a room to talk about patient safety and what do they come up with? In the last couple of decades they came up with the liability limitations for themselves that increase their position as the overlords of powerless patients.

Is anyone working on a plan that does not further entrench us in that paradigm? All of the talk about Patient Centered Medicine only further entrenches us in that model.

And Transparency - the thing benevolent overlords are supposed to provide in spite of their conflicts of interest and the self serving lens through which they see the world - keeps all of the information about medicine in their hands.

When medicine makes patients better it is advertised. When it makes them worse 93% of the time no record is made of it at all. That is what overlords do when they are not benevolent.

Neither providers nor patients can make informed decisions without knowing what providers never have and never will report.

Ludwik Fleck, a physician, said that "to see" means to recreate a picture created by the mental collective to which one belongs. This is true of the caregiving community. For instance, it sees itself surrounded by frivolous suits rather than patients it has injured. And it sees as good for patients treatments that are good for itself no matter how bad they may be for patients (examples are on the site).

For patients to survive in spite of this requires information about medicine that has not been filtered through the self-interested mindset of the medical community.

Objective information is the foundation for reducing the unacceptable rates at which medicine bankrupts, injures and kills patients. Patients must be able to learn where safety, efficacy and affordability lie. Doctors do not steer the patient community around even untrustworthy caregivers and facilities, let alone around the incompetent and/or outrageously expensive. They never will. This is a job the patient community will have to do.

Neither providers nor patients can make informed decisions without knowing what providers never have and never will report. Health Care Professionals do not have the objectivity necessary even to recognize such information. The information necessary to make safe decisions can be collected only by people who are not in the employ of medicine.

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Loyalty is the core operating ethic of medicine, not integrity, and not safety. When things go wrong, disloyalty is what ends careers. Failing or refusing to report problems does not end careers. Failing or refusing to help patients does not end careers. But being disloyal to colleagues does. And loyalty is maintained through self-serving delusion, denial and silence about the people and problems harming patients.