To change something, build a new model that makes the existing model obsolete.
-R. Buckminster Fuller
One of the beliefs that patients have been force fed by medicine is the idea that medicine is too complicated for patients to understand and make sane decisions. It is in medicine’s interest to believe that and to keep you deluded enough to believe it too. When you are getting a hip replacement, they are required to educate you so that you can make the decision about which one to get. They explain to you the two different ways that the operation is done – information that would be useful if you were trying to pass a course in medical school but of no use for the decision you are about to make.
If you were trying to make a decision about which of two cars to buy, two cars you had not seen and knew nothing about, and got all of your information from the person selling it to you, would it help for that person to tell how each one was made? Or would it have been better if you could have learned that one of the two had a history of blowing up more often than any other car in history?
Comparative Shopping
For twenty years millions of patients around the world were told about how two different hip replacements were made and installed. Do you think a single one of the doctors “educating” those patients mentioned that the metal on metal one would put toxic levels of cobalt into their blood streams, and that perhaps a third of those patients would come down with dementia, blindness and/or heart failure as a result? What patients need to know is what has been the outcome for other patients 6 months ago, a year ago, five years ago, ten years ago. And especially, what has been the cost and outcome for patients with this operator in this facility compared to other operators in this facility and other operators in other facilities? All of that is information that no one in medicine ever will be objective enough to collect for us.
Currently, no one in medicine tracks anything like that. They do not want to know it themselves. It is not in their records. It especially is not in their minds. Only 2% of what goes wrong in medicine gets in the record accurately. 93% never get in the record at all no matter how overt and damaging (see medical reporting). Violent crimes committed against patients in front of witnesses get no mention in any record. It can end the career of a health care worker who does put it in the record . A year later none of the witnesses even will remember it, such is the nature of human memory. It is only the traumatic memories of victims that are immutable. 40 years later war veterans who have been victims of such repeat the exact same story they told minutes after it happened. All other memories humans automatically rewrite to suit their own purposes over and over again as time goes on.
Here is how that plays out
The physicians who refuse to diagnose the injuries of patients who were injured in medicine do not believe that patients cannot get diagnoses of injuries incurred in medicine.
That is all you really need to know to understand how people in medicine think and make records. They do not even make an accurate record of why injured patients came asking for help (and do not believe they don’t). Injured patients can find nothing in any record about what happened to them.
This disables the ability of patients to make informed decisions. That suits the purposes of people working in medicine. It does not mean people in medicine are evil (well, okay, sometimes it does). But it definitely means they are not saints. They are humans. Humans perceptions and memories are self-interested. One of the problems is that in medicine they believe they are not. The first, biggest myth believed in medicine is that they believe they are objective and selfless. Stupidly the patient community believes whatever these authorities believe. But what else do patients have to go on? There is almost no information available to them except that which medical professionals choose to gather and record. Patients cannot make safe decisions with only 2% of the most important information necessary for doing that.
If you wanted to hold a contest to find the most subjective person on earth, the first requirement to gain entry into the contest would be to believe that you are objective. People who imagine that they are objective are among the most subjective people on earth. If people in medicine were not, if they truly held the interests of patients above their own, they would have explained to patients that metal on metal hip implants were toxic. Instead, they stayed in line with one of the mantras of medicine that says “Don’t go looking for problems” and did not put two and two together when their patients came back with problems caused by cobalt poisoning.
Medicine unnecessarily kills as many people per week as firearms kill per year (see Preventable Deaths). Medicine is the most dangerous place most people in the USA ever go. It is outrageous that patients have no ability to see what and where the dangers are so that they can avoid them. It is possible to collect the information that will enable them to do that. It is not “big data.” It is small counting. If we tracked just 3% of patients, we could learn an enormous amount of what is necessary for patients, for the first time in history, to be able to make the very first judgement any patient must make, and that is whether the risks of seeking care are greater than the risks of not seeking it for a particular set of symptoms. How could we get 3% to sign up for tracking? Have you ever spoken to a patient injured in medicine? They get so that they wish they could get all the information about their own cases on the front page of any site or newspaper that would show it, just to try to prevent what happened to them from happening to anyone else. But they cannot even get their own primary care physicians to make an honest record of it.
Small counting
There are cases like the physician who groped adolescent girls year after year. The girls were screaming mad. The parents were screaming mad. The state medical board did nothing. The police would not do anything. The press would not listen. What is typically the hope of last resort for patients, lawyers, would not take the case. The physician got away with it for fifteen years, by which time enough of the girls had become adults to bump into each other socially and form a group. A group of adults with the same memory still cannot get help from state medical boards or the police, but they can get a lawyer (even though not a medical malpractice one). It should not take fifteen years and hundreds of victims to be able to do something about such a problem. With a little data collection, this could have been addressed back near the beginning. There is low hanging fruit. Tracking all the data of a small percentage of patients will uncover some of it, which will result in those patients asking to be tracked, which will uncover more. It will grow.
That it is what this site is about.
Solutions ……….|………. Problems
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……………………. | ………… Myth #1
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Patient Agency… | …………………….
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Nequamitis ……. | ……………………
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……………………. | Conflict/Interest
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……………………. | ………… Loyalty
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……………………. | ..Wall of Silence
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……………… …… | …….Blacklisting
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…………………… | ….Psych of Care
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…………………… | … Transparency
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…………………… | .. Charles Cullen
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…………………… | Orville L Majors
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…………………… | ……… Kayshyap
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…………………… | ………….. OSMB
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…………………… | ….. Semmelweis
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…………………… | . Benjamin Rush
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…………………… | …. Government
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Patients Boards. | ……………………
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Campaign … | ………………
“If we can get just 10% of people to be smart patients, it will change the system.” – Mehmet Oz, surgery professor.