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Friday 21 February 2020

Patient Choice. What if a Visit to the Doctor went like this?

When we are sick today, a visit to the doctor always ends in the same way. The doctor listens to our problems. We are asked questions by the doctor. We undertake some tests suggested by the doctor. The doctor diagnoses what is wrong, and writes a prescription for pharmaceutical drugs.

That is how our dominant, monopolistic, pharmaceutical-led medical system works today. We are sick. And we get pharmaceutical medical treatment - whether we like it or not! There is no health freedom.

So what would happen if our health services were operated on the principle of Health Freedom? What if Patient Choice held sway within conventional medicine. What if the concept of "no decision about me without me" was put into operation. What would a visit to the doctor be like then?

Probably much the same, at least to begin with.
  • The doctor will listen to our problems. 
  • ask us questions. 
  • perhaps undertake some tests. 
  • then the doctor will diagnose what is wrong. 
But then the doctor will provide us with information about the choices we have - we would be asked about our treatment preferences.

So let's suppose we have some sort of pain, perhaps lower back pain, or fibromyalgia, or rheumatoid arthritis, or osteoarthritis.
  • The doctor will probably do what (s)he does now - offer us painkilling drugs; but now we will be shown the Patient Information Leaflet, which includes information about known drug side effects, and (s)he will explain how painkillers only dampen pain for a short time, a palliative response to the pain that will not be effective in treating our illness.
  • Patient Choice. The doctor will then reach for several leaflets outlining other forms of treatment, perhaps dietary and nutritional advice, physiotherapy, osteopathy, chiropractor, naturopathy, homeopathy, acupuncture, Alexander technique, yoga, and many others.
  • Informed Choice. We would then be asked to read the leaflets. The leaflets would be written by health professionals who are qualified in their particular therapy. On this basis we would decide which treatment we would prefer to use.
  • No decision about me without me. Alongside the doctor we would then make our decision. We would have the option of working directly with the doctor with pharmaceutical medicine. Or we would ask for, and the doctor would refer us on to a naturopath, a homeopath, an acupuncturist, et al., for a course of treatment of our choice for a defined periods of time.
  • Patient Outcome Assessment. At the end of an agreed period of treatment we would return to the doctor, tell him how we are, and in particular whether our pain was worse, the same, or improved. 
  • On the basis of this, alongside the doctor, we would fill in a form to assess the outcome of the treatment.
  • The form would then be submitted for analysis, along with millions of others, to assess the outcome of the treatment for the patient. 
  • Comparative outcomes of the different treatment therapies for similar conditions would then be calculated.
  • Treatment outcomes would then become part of the information provided to us at every stage of our treatment.
  • Further Treatment. The outcome of the discussion would be a decision about further treatment, whether to continue with the treatment for another period, or to try another kind of medical therapy. And the process would begin again.
We have freedom of choice in most other spheres of life
- so why not in medicine too?