Fake Medical Care. January 19, 2018

 Your doctor isn't just a health care provider. She's also part detective, using all the clues and evidence you provide to arrive at a diagnosis and then using that determination to develop an appropriate treatment protocol. It's not always a straightforward process, and it's important that you provide as much information as you can to facilitate arriving at a suitable diagnosis and treatment
US News Health.
 https://health.usnews.com/health-care/patient-advice/articles/2018-01-16/how-to-make-sure-your-doctor-understands-your-medical-condition

Sound very reasonable, is not it? Take closer look at this statement, may be there is something wrong as you see it?
      On the paper it look great. You come to clinic with all papers and questions you wish to ask doctor.  Doctor is very nice and ready to provide good care for patients' needs. Not so many doctors ready to listen. Your doctor is devoted to patients. What does it mean? There is line in waiting room. Right? Long line. Good doctor is rare in our time. Every one do know it. Every one shopping for the best we can find.
     Finally you got to the doctor's office. What is first and what is next? Who suppose to start the conversation, you are asking questions you are ready to ask? Doctor, who sees you not first time? Better to say in this case doctor will ask how do you feel.
     Now, let take a look back to article. How we suppose to answer to this question? Really, all the time I answer, I am good, or OK, consider my complex health issue. If I am first time in office, then is this possible doctor would listen all my info I do have to address? Really, how patient suppose to get ready to visit? All what we can say, we do have issue with pain or complications in health. Then our prime doctor will sent us to the specialists. When I am in specialist's office, what info I suppose to give? The same as I already say to prime doctor, and this is not too much. My expectations are that doctor will ask questions, order tests, determine diagnose and Rx treatment. Do not be so fast.

      "Your EHR was designed to maximize billing, not to help your health" Eric Topol. Tweeted.

I hope every one do know this statement.  So, does doctor ready to spend time with patient? The payment was already promised. We can go out without stopping in doctor's office. Payment will be previded. The rest is not important. No one care if diagnose is right or treatment is effective. It is not important. The important is, the billing and payment. In this duo there is no spot for patient's needs.
     Still, I suggest to skip reality and move to ideal doctor who is devoted to patient and ready really to do best he/she can do in Art of Medicine. Doctor is ready to listen. Patient is ready to talk. About what? It is not rhetorical question. It does not mean that we can discuss last Tosca in The Met. The question is, where to start? How patient do know what info important and which is not? THe author of this publication suggest what is already done with nurse and at first with scribe.
      Scribe in Modern Medical Care the High School grad who stand between patient and doctor. So, scribe ask questions as much as she can. Scribe has no one idea about medicine, or medical condition. Scribe ask basic questions to safe doctor's time and energy. Patient, who is already very weak and ill hardly able to speak due to stroke, must answer to all those questions which are absolutely not relevant to any condition we are in right now. Time is crucial for stroke patients. There is no time for questions. Patient not able even to understand the questions because of semi unconsciousness. Scribe ask question. It is important to her to hold her job.
      This is reality. But we look at the ideal situation. Scribe call to doctor right away with alarm, it is emergency situation. What doctor suppose to do? In clinic or ER there is patient with active condition of stroke. What doctor can do in this situation? Take a look at the page of Eric Topol. He gave perfect answer to this question.
https://twitter.com/EricTopol?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor
What reall doctor will do in situation like this? Discharge patient from hospital.This is best way what doctor can do. Someone will go to another hospital to find the help with is really too late. Someone will survive. I did survive. I went to three hospitals. The treatment was the same. Now I think, it was the best in situation I was.
      Still, why the situation like this happened? Why patient sent out of hospital when it is active stroke? Remember, the point is Ideal Doctor. What really Ideal Doctor, highly devoted to patient's needs, can do?
      To find the answer to this question, really very simple and logical,  go to Eric Topol Medscape, or any other issue Medical Care publish very widely. What do you suppose to find  in all those medical education issues?
Eat Right.
Work Out Regularly.
Do not Smoke.
Now Ideal Doctor one-by-one in room with patient in cute stroke condition. What doctor suppose to do? What really doctor can do? Not too much. Any treatment is 50% -  50%. But on the others side is doctor's live. Also 50% - 50%. If doctor do something and patient die then doctor is responsible for the act he/she took. If doctor sent patient away from clinic or hospital and patient died on the way home, then there are nothing what doctor could do. Patien's choice.

via Ravenvoron