More Medical Care Isn't Always Better

Posted by Patrick Lickiss on Jun 7, 2010 in Current Events, Politics | 4 comments

First off, I’d like to apologize for my longer than expected absence.  I was taking a family vacation and just couldn’t bring myself to sit down in front of a computer when I could be sitting on a beach instead.  I have an article slated to post on Friday, but in the mean time I’d like to share a link to a story listed on a local new site.

I have long stated that technology and the Internet has made our jobs easier and more difficult at the same time.  I can assume that many in the EMS community have heard a medical complaint at least once that started with: “Well WebMD said that I should call 911…”  These calls can generate a large amount of frustration for responders and can tax an EMS system already running thin.

Internet-fueled medical calls notwithstanding, technology has also vastly improved the care we provide to our patients.  New assessment tools and standardized documentation procedures have increased our ability to perform differential diagnoses in the field and have improved our ability to transport patients to the proper facility.

The article mentions a variety of assessments and treatments (including CT scans, cardiac stents and antibiotics to name a few) which are performed on or given to American patients which are likely unnecessary.  Out of fear of legal ramifications or being accused of “rationing” healthcare, physicians and politicians are making a potentially fatal mistake: they are allowing patients to dictate their own care.

Note: I’m going to step up on my soapbox now, so let me reiterate that these are my own opinions and do not represent the opinions, legal or otherwise of any other entity.

So what, you may ask, is the problem with allowing patients to dictate their own care?  Shouldn’t people be allowed to get the care they need and deserve?  My answer is absolutely yes, people should be allowed to get the care they need.  Physicians spend years going to school to finish their MD and spend further time working on a specialty.  The average American coming to their primary practitioner’s office asking for a test or prescription is likely drawing from educational background as broad as a recent television commercial or maybe a national news magazine.  People place doctors on pedestals and then don’t trust these same providers to make treatment decisions.  It’s high time that Americans (all of us, including those of us in EMS) start letting our medical professionals make the treatment decisions.

The article talks about steps being taken to educate physicians about overused tests and treatments.  Programs such as these should help because they serve to protect physicians by establishing a “standard of care” that doesn’t include rampant overutilization of potentially harmful tests and procedures.

The article also mentions an important program incorporating patients and physicians in “shared decision making”.  I think we can all agree that the best way to work towards decreasing overutilization of medicine is to educate the patient population.

Given the massive amount of money spent every year on healthcare, it seems reasonable that one of the only ways to curb healthcare costs is to put treatment decisions back in the hands of the practitioners.  While this shouldn’t be done at the cost of patients, the average patient (even the average paramedic) is simply not educated enough (and is easily swayed by advertising in the media) to make those kind of decisions.  If we are going to cut back on unnecessary and potentially dangerous medical care, we need to educate ourselves and our patients before we will have success.

So now I put it to you: in the spirit of EMS 2.0 and community paramedicine, how can we help to educate our patients on a daily basis to help reduce overutilization of all medical services (not just EMS!)?  We are on the front lines of medicine and have an excellent opportunity to contribute to the solution to a dangerous and expensive problem. I look forward to hearing your ideas!  Stay safe out there.