Saturday, October 31, 2009

Health & Care

I had a series of shabbes conversations on health care today. What astounds me is the often callus regard physicians have for their patients sentiments. They agree that the highest level of care should be provided to every patient, but that excessive wait times (5 hours in the emergency room) and curt explanations are just a fact of life. Deal with it. Often, doctors claim to be exceedingly busy and unable to spend the necessary time to explain their diagnosis to patients and do general hand holding. My instrumental counterclaim is that more time hand holding will yield fewer malpractice suits. My friend's response was, don't sue so much and your health care premiums won't go up so fast. This is obviously silly, as the the cost of malpractice suits is 1) negligible to the entire cost of health care in America and 2) shouldered far more by doctors than patients. The reply strikes me as exceedingly arrogant, however, and reveals a certain bravado amongst physicians.

What really bothered me, however, was my inability to give a non-instrumental argument as to why health CARE is important. Why am I owed an explanation? I come in which a life threatening illness that almost kills me. Doctor enters, grunts, writes a prescription, and leaves. Five days later I am totally healthy but without a whit of understanding as to why. Has the doctor shirked her responsibility? Is she blameworthy? I feel like I could offer some souped-up Kantian 'respect' argument, but somehow that feels forced. Are we entitled to care, above and beyond health?

5 comments:

Anonymous said...

No.

-OB

Yehuda said...

Are we entitled to good health? In what sense?

Zev said...

Nattering nabob Mr. OB... or maybe I am the nabob, considering I am the one whining. Such hard determinations.

Yehuda, no. Only God can give health, and I don't really feel that I have much coercive leverage with Him.

Yehuda said...

Doctors often are exceedingly busy and hospitals are generally remarkable well run. I am not sure what you are complaining about: would you prefer to have Robin Williams dump you in a vat of noodles? When you say "care" you seem to mean two things: one that doctors should make you feel good and the other that they should explain what they are doing. I myself always prefer explanations, but why do Americans always need to feel good? Should doctors who are frequently grumpy not be permitted to see patients because they'll ruin their patients' day?

Anonymous said...

What you leave out is the possibility that health and well-being outcomes themselves might be better if people got what you call "care." I.e., maybe more of what you call handholding will lead to healthier patients. In your example of "doctor comes in, grunts" etc., perhaps the procedure is more likely to "work" if a doctor does the same things, ministerially, but also makes an emotional connection. Healing has a serious, and overloked, non-physical component.

There are many illustrations i could draw from obstetrics, and probably elsewhere, if you are not convinced...

Miriam