Broken medical culture
Was medical culture ever healthy?
Experiences with misdiagnosis, medication side effects, wrong-side surgery etc. fuel a gigantic medical malpractice industry in the United States. In Canada, the malpractice angle is stifled for various reasons, and instead our discussion revolves around wait times.
Health care is tricky. Today, a neighbour shared her angst at constantly battling nurses and physicians who insisted on having her hospitalized father lie flat every so often.
No big deal, right?
However, her father had terrible gastroesophageal reflux, combined with a tendency to aspirate. The end result was a tendency to get aspiration pneumonia if he was lying flat and had anything in his stomach.
While she had success with some of his doctors, and some of his nurses, in making sure this very boring but essential detail was observed - don’t lie him down flat - there were other nurses and doctors who ignored her.
And gave her father pneumonia, over and over.
What exactly is broken here?
A few things: 1) a tendency to ignore family concerns; 2) lack of training and knowledge regarding how to prevent aspiration pneumonia; 3) patient charts that omit boring and yet vital points of care.
How to heal a system like this - a system that is broken all over the world?
Medicine seems to work much better as a small business, in places where practitioners are also socially interconnected with patients. "Big" medicine is fraught from the very start and vulnerable to capture/corruption. It also is conducive to seeing patients as things to be processed, rather than beings with essential worth (not to mention souls...).
The problem is that medicine, until quite recently, didn't know much. But the placebo effect is powerful. So doctors could heal though it. To do that, they had to show confidence, not doubt or uncertainty - the hallmarks of science.
So doctors have a tradition of being unscientific and showing undeserved confidence in their own knowledge. Until recently (20th century), that was best for patients. Now things are different, but traditions are slow to change.