Navigating Healthcare – Patient Safety and Personal Healthcare Management

Patients and Doctors Need to Reform Too

Posted in Healthcare Information, Personal Health Record by drnic on April 13, 2009

There is much discussion and commentary on the Healthcare Reform, new clinical systems and the investments being made through the stimulus package. But not so much has been written about Patient reform. The NY Times piece A Hurdle for Health Reform: Patients and Their Doctors focused on the issue of patient and physician behavior and the all to frequent insistence on treatment can be a poor choice. It is a poor choice for economic reasons – why pay for a treatment that has little or no effect. And why start using a drug that has no demonstrable improvement in outcomes vs an older well tried and tested drug. Apart from the fact that we already pay 77% more for comparable drugs – in no small part due to the effective lobbying and marketing drug industry machine. But we also find our treatments based on Physician Pillows (they reflect the most recent impression left on them – often by drug companies) for a newer supposedly better drug but:

when it comes to comparative effectiveness, the track record of the American public and their doctors is not encouraging. Even when such comparisons are available, we tend to ignore them. In 2002, for example, one of the largest government-financed clinical trials ever found that generic pills for high blood pressure worked better than newer drugs that were up to 20 times as expensive. But most hypertension patients still use costlier drugs marketed by pharmaceutical companies

Of and by the way – the side effects for these newer drugs are by the very nature of their recent introduction as yet undiscovered, so the American public is providing a great service to other countries and their patients testing out new drugs on their behalf! If you’d like to read more I can recommend this book by Marcia Angell, a senior lecturer at Harvard Medical School “The Truth About the Drug Companies: How They Deceive Us and What to Do About It“. Shocking insights into the industry that is there to make money. The first recommendation on Amazon is pretty compelling

I should start with a disclaimer. I’m a Vice President within one of the largest drug companies in the world and I have spent close to twenty years marketing drugs. So I guess I’m not supposed to like this book. But the truth is I thought it was fantastic. First, for those of you who are not familiar with the healthcare industry, you should know that Ms. Angell is better capable of writing this masterpiece than any other author. She used to be Editor-in-Chief of The New England Journal of Medicine, which is considered the most prestigious medical journal in the world.

But this volume is much more than simple entertainment. It is quite possibly one of the best analyses of the state of the U.S. drug industry today, complete with footnotes backing up every statement the author makes. You will learn not only that in 2002 the top ten drug companies made a higher profit than the other 490 businesses together on the Fortune 500 list. You will also understand how the drug industry has been able to achieve such a business success and how this success, as is often the case throughout history, will likely be their downfall

Yikes – and this from a Drug Company employee!

So what to do – start with more education, include and understanding of what works and what does not and above all else, don’t take the treatment you receive as gospel. Would you pay for “Synthetic” oil for an oil change that is more expensive without understanding why it is worth spending that extra money – if indeed it is. I hope not. The same should be true for your health and with the availability of information, support groups and tools to analyze healthcare will be a much more inclusive process involving the patient and the whole team in making decisions than it has in the past.

Do you have your own experience of good or bad choices;  if so please share them and let me know what you think f the current state of healthcare today


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