Monday, August 19, 2013
Girls, Fast Cars, And Healthcare
Moments later, we were off.
The radio blared and the windows were open. My hair flew spastically in a multitude of directions. I patted the wayward tendrils and keened forward to listen. The conversation in front was lost in the rhythmic trance of radio waves. Expecting the joy ride to be over soon, I held tightly to my seat cushion as the car swerved onto Lake Shore Drive.
The rush of air was just enough to totally ablate the wild and carefree screams of the young girls in the front. Picturing them now with animated but mute faces would surely give the pair heartburn to know that this was my lasting, silly impression. I watched with slight horror as the odometer began to climb.
40, 50, 75, 100mph
We weaved back and forth through traffic. I closed my eyes tightly as the near misses became more near and less misses. I braced myself for the imagined impact. With relief the car began to slow and pull over to the right. The music was abruptly stopped, and the sound of approaching sirens filled the air. The policeman sauntered out of the squad car, and rested his elbow on the open driver's seat window. He looked at the two crimson faces in the front, then smirked at my pale white facade.
Her license was suspended for a year.
As I grew older and more confident, I developed the ability to speak up and not get myself into such situations. But as a hormonal teenager, there was definite gain in remaining silent: being cool in front of the object of my affection.
Unfortunately, as adults, we are confronted with many similarly confusing and difficult situations. Being a doctor, my patients often ask for tests or treatments that I don't feel comfortable dispensing. Every day I am approached for antibiotics, narcotics, and cat scans, usually in the absence of medically reasonable indications.
And like the teenager, there are many gains to being silent and acquiescing. Happier patients refer their friends. Happy patients rarely sue their doctor. Happy patients score their physicians better on quality surveys.
Yet studies are beginning to show that contented patients cost our healthcare system more, and suffer greater morbidity and mortality.
I'm all for shared decision making. When reasonable options exist (including declining care), I believe our patients should be fully informed. But some in the ranks of healthcare reform opine that patients should always be the driver of care. They say that a well informed patient can make the right decision even if it is deemed by the physician as unnecessary or even harmful.
To me, that sounds alot like getting in the passenger seat of a car with a sixteen year old girl for a 100mph joy ride down Lake Shore Drive. It may sound appealing at first.
But in the end it's downright dangerous.
Posted by Jordan Grumet at 3:55 PM