Standing Up Against Patient Empowerment

Doctors still don't get it. It seems that every chance they get, docs will try to block even the most modest efforts to provide patients with a little power within our health care system.

The latest example is the effort of the Allegheny County (Pittsburgh, PA) Medical Society to put a halt to health screening services conducted in venues not associated with physicians' practices.  Such health screenings typically are done under the auspices of local churches or community groups, and include testing by ultrasound for narrowing in the carotid arteries, aortic aneurysms, and osteoporosis.  The testing is paid for directly by the patient.

This seemingly benign health screening is a problem for the county medical society.  Ostensibly, the concern is that there is no state oversight as to whether the screening is "a valid service."  The docs are concerned, it seems, about protecting the consumer, and intend to do so by bringing such screening services under the state regulators.

The state department of health does not seem anxious to take on this new role.  A spokesman for the department of health points out that there are mechanisms in place if patients should have a complaint against such screening services.  This spokesman points out that, further, state oversight of these community screening services is no worse than the oversight given to the same services performed in doctors' offices (and, the implication being, quality is likely to be no worse, either.)

DrRich Comments:

In an ideal health care system, community screening services would be unnecessary, because everyone's doctor - working diligently with only the best interest of his/her patient at heart - would see to it that every proven preventative tool, including this sort of screening, would be applied to each and every patient who might benefit.  Unfortunately, under a system of covert rationing, doctors who find too many asymptomatic-but-threatening conditions, then opt to provide expensive treatment for such conditions, may have to pay a high price for their diligence. 

Ten years ago DrRich might have agreed with the county medical society - this sort of screening is best done by an individual's own doctor.  Today, DrRich is in favor of any measure, no matter how modest, that encourages patients to take the bull by the horn and find ways to safeguard their own health.  Unless patients (the only entities left in the health care system for whom their health is actually an overriding concern) do so, they will remain at the mercy of an increasingly hostile health care system fully engaged in the covert rationing of their care.  Self-empowerment is the only true safeguard, and any doc who stands in their patient's way is not their friend.

April, 2004

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