Paternalism in Medicine

November 16, 2006 Category: Uncategorized

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By: johnnyb

Hey guys this summer I did recitation for a drugs and behavior class. Part of my responsibility was to bring up some discussion points regarding drugs legal and non. Anyway I found this blog on the topic and shared it with the class; I don’t think they were ready to read for the most part, and certainly not ready to think outside the box so to speak. I know the same doesn’t apply to our faithful readership. An excerpt:

By Trent McBride:

Any claim that paternalism is an artifact of medicine’s past is simply wrong. Even though the culture has improved recently, it still lives with us today and it has no appearances of going away anytime soon. In other industries, service models revolve around a customer who hires someone to serve her needs. In medicine, doctors, with an assist from the federal government, have a dominant position with regard to the patient and have a unique amount of control over their paying customers. Many people may disagree with this characterization, but I fail to see anything different in spite of recent efforts to change this relationship. Patient autonomy does not exist in any way like it should.

In no area is this more apparent than in the prescription-only status of most medicines. It always amazes me that this fact is never called into question, especially among my medical school colleagues. There is no shortage of debate in and about medicine on just about any other topic, but we accept this culture of the gatekeeper almost without question. You would think just once you would here somebody say, “Doesn’t anybody find it odd that it is illegal for this patient to by this drug unless I write it down on a little piece of paper and then sign it.” Maybe I lack imagination, but I can’t think of another aspect of the human experience where one set of people, not members of the government, wield that amount of power over others.

the entire post is very thought-provoking. Click the link above to read.

Dr. Woo part I

August 21, 2005 Category: Uncategorized

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By: johnnyb

Earlier this summer I was having intermittent but painful stomach cramping. Every two or three days, interminable cramping and constipation. I didn’t know what the heck was going on. I never had GI problems before. After a couple of weeks it gets to the point where I threw my guts up in the bathroom…something I hadn’t done in years. Well, I decided to go see the doctor. The friendly university clinic doc prescribed a laxative. Maybe a good idea. Except three days later the pain came back even worse.

To top it all off Yun-ju and I decided not to get air conditioning this summer. After all, last summer it only got up to 90 three days of the summer. It’s not like Louisiana, or South Carolina, if you know what I mean. So to save a few bucks we say no to buying and installing an air conditioning unit. One good result of this is that door-to-door salesmen pass by our apartment without knocking, thinking that we are too destitute to buy what they are selling. To this end we have also purchased a bottle of “That Smell”. You know “That Smell”, which lingers in the soggy trailers some of us may be familiar with, for some reason or another.

So, I’m writhing around in the heat and pain and decide to spend my Friday night (4a.m. ish) visiting the emergency room, where I first visited the bathroom. Pain pills and water…nothing was staying down.

The first thing the nurse said is, “we’ll get you an X-ray and a CT scan” Sounds frickin’ good to me. The warm towels feel good (maybe not 892$ worth of good, but I’ll get to that later). Some intern with gray hair came in and asked, “So what brings you in here today?” and “On a scale of 1 to 10, how much pain are you in?” I realized this is pretty much the extent of service you get without serious trauma. I geuss he figured I was enjoying a friday night/saturday morning in a meat locker with a warm towel. Then the brilliant real doctor comes in and asks the same series of questions. I keep wondering if there is, I don’t know, some kind of chart or maybe a record a doctor could read from so they don’t have to ask all these questions. I explain to this doctor that I’m going through this cycle of two days or so of no pain followed by a day of intense pain. He asks me which part of the cycle I’m in now. “The pain part!”

Apparently I wasn’t convincing enough because I got no tests. Three hours in the hospital and no progress. Life ain’t like “ER”. I did get half a liter of 0.9% saline (300$), which costs ~8$ when I order it in the lab.

Posted at 11:42 pm by Johnny B

Posted by BP @ 08/21/2005 11:51 AM PDT
I am waiting with baited breath for the rest of this story.