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Re: U.S. physicians...From: Dr Eberhard W Lisse (el@lisse.NA)Mon Dec 25 01:25:16 1995
Joe,
At 2:36 PM 24/12/95, DoctorJoe@aol.com wrote:
><<And it is a natural phenomenon that US physicians routinely disregard their patients' wishes, something I read here quite often but has recently been written up.>>
>Actually, while you get some sense of this from the midwife-physician flame wars that occasionally pop up here, my own sense of this is that the doctors who act this way lose, in the long run, the best and largest patient bases. In the US, we still have (hanging on by a thread at times) a free market economy. Patients show their allegiance to their doctor by making appointments; they show their displeasure by either walking, or filing suit.
><<On the other hand these decisions are made by health insurance carriers, hospital administrators, lawyers etc (eg whether to deliver breeches by vagina at all etc).>>
>This is probably the BIGGEST problem. I think the health insurance problem will solve itself (still a free market economy - the patient will make things work). The other part of this, primarily the TRIAL LAWYERS, is where the BIG problem is that won't necessarily go away.
><<Why is it, by the way, that the US perinatal mortality is higher then in other comparable countries such as Canada, UK and Germany? Why is it by the way that the perinatal mortality in Orange County, Florida is as high as in a developing country>>
>I think the major reason is the heterogeneity of our population. We don't have a uniform population, like perhaps Sweden. In some areas, primarily the inner city of large metropolitan areas, we ALMOST DO have a third world country. I know in downtown New Orleans, we have a select group of high risk, low compliance, self abusive, primarily minority patients who only need malaria and sleeping sickness to qualify as a third world country (and we are currently watching for malaria, since there is a new brand of mosquito here that is capable of carrying it, and dengue...). Sweden does not have a uniform population. It is a huge country with rural and urban communitites and a large number of immigrants. Canada does not have a uniform population, neither do the UK or Germany. No this is not the reason. The reason is that the health system in the US is not tending to the majority of your population. Basically as you say, free market. However, who can afford you? el
-- Dr. Eberhard W. Lisse \ / Swakopmund State Hospital <el@lisse.NA> * | Resident Medical Officer Private Bag 5004 \ / +264 64 461503 (pager) 461005 (home) 461004 (fax) Swakopmund, Namibia ;____/ Zone/Domain Contact for the NA-DOM Vice-Chairman, Board of Trustees, Namibian Internet Development Foundation, an Association not for Gain. NAMIDEF is the Namibian Internet Service Provider.
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