"How Doctors Can Think Better" | Arthritis Information

 

An interview with the author of How Doctors Think:

http://medicaleconomics.modernmedicine.com/memag/Latest+Articles/How-doctors-can-think-better/ArticleStandard/Article/detail/518769


"

Kane: With today's shorter patient visits, pay for performance, and evidence-based medicine, doctors are encouraged to use algorithms and decision trees to diagnose. The system doesn't encourage doctors to take more time for open-ended thinking. How can doctors find the time to think more and still make a good living?

Groopman: The system has gone headlong into checking off the boxes and following all the outcomes and decision trees. I believe medicine is still something that requires an understanding of the individual.

I've spent years in research for evidence-based medicine, and I'm very aware of the limits and deficiencies of how those data are used. They reflect a very, very cherry-picked group of patients. They use patients who aren't on seven medications, and they come up with statistical averages. How closely does the patient in your office correspond with the data-based medicine? Are you supposed to say to your patient, "Please leave my office, you don't fit the data"?"

My, oh, my sounds like the ACR's new circles and arrows chart.....

Pay for performance is going to be a real problem.  In Home Health Care for instance, I taught people what they needed to do to manage their disease, yet when they are non compliant and end up in the hospital, we get less pay. 
Copyright ArthritisInsight.com