Navigating Healthcare – Patient Safety and Personal Healthcare Management

Self Care and Management

Posted in Healthcare Information, Personal Health Record by drnic on August 5, 2009

In a great post by Don Kempler (CEO of Healthwise) on the Healthcare Blog titled “Patient Heal Thyself” the challenge of health management and the over usage was very clearly addressed by comparing two families – the Jones’ and the Smiths

The Smith family represents the vast majority of healthcare usage in the US – Doctor knows best and is typified in my experience with the frequent visits for every ailment that crops up. The Joneses are at the other end of the spectrum and much more conservative using the information they find and more importantly applying it as part of their interaction with their physician

For the same condition of back pain they represent the cost both financially and also from a health perspective
The Smiths (Doctor knows best):

When Sam Smith’s back pain flared at age 45, he was quick to accept his doctor’s recommendation for an MRI and a visit to an orthopedic specialist to make sure it wasn’t serious. The MRI showed a possible cause of the pain and (just to be sure) Sam had surgery the following week, marveling at the efficiency of the system. The cost: about $40,000 for surgery, hospital, physician care and rehab.

For the Joneses with the same condition:

When Jay Jones, also age 45, had an identical bout of back pain he reviewed a back surgery decision aid on the Web—even before his first visit. He learned that back surgery is not usually needed or always successful. For him the case for surgery was not very strong.

When his doctor recommended an MRI, Jay pointed out that a decision aid helped him learn that 50 percent of back pain cases go away in four weeks, 90 percent in six months, and only 10 percent of back pain cases need surgery. Jay also learned that MRI reports often find things that can lead to surgery even though they were not the cause of the pain. With that information he asked if he might put off the MRI and the surgery while he determined if his back would get better on its own—it did. The cost: $150 for the office call and $12 for the over-the-counter medications. Back surgery is among the most over prescribed treatments.

Now not everyone is comfortable with the self diagnosis and I blogged about that some time back in this piece on online symptom checkers but that the point is not to defer the whole diagnostic process to technology but to use the technology to help support decision making.

I know where our family is (sometimes to the chagrin of my own children who feel I am less than sympathetic) – we use the services when we feel we need them and are very conservative. Intervention and investigation is not always good as we discovered in the hospital I commissioned a number of years ago. To check the equipment the staff were asked for volunteers to test the MRI machine – it was a very short run as no soon as we put people into the MRI but we discovered “abnormalities”. In this case abnormalities that were not abnormal but normal variations but the cost in time and investigation was high on the institution and on the individuals and the tests ere stopped.

Using good judgment and being a Jones family is better for your health and better for your wallet.

Which family is closest to your style. Had good or bad experiences with either style – let me know


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