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6) YOU ARE IN THIS TOGETHER.
Studies show that patients with poorly managed
anger and pain may feel stress, fatigue, anxiety,
depression, and guilt. Your mutual understanding
of what is happening can make the difference. You
are not in a normal situation. You can't expect a
normal relationship.
SORTING THROUGH BIAS TO GET TO WHAT
IS BEST FOR THE PATIENT
Definition of Bias: "A particular tendency, trend,
inclination, feeling, or opinion."
BIAS FROM THE PATIENT'S VIEWPOINT
:
1) Convenience bias: I want to be treated at a
hospital close to my home.
Having spent over a year at a treatment
center 600 miles away from our home, I'll be the first
to tell you it is tough! Not only are you ten hours away
from your life (parents, kids, pets, and so forth), you
may have to fight for the referral if it's out-of-state.
Here is the most important message of all...the
hospital where Gordon was first treated had a great
neurosurgical team to remove a cancerous tumor
from his spinal column. Where they fell short was
treating his type and stage of cancer. They should
have given him a referral to begin with...so why did
they treat him at all? Hospitals are a business...a very
big and expensive business. They have research to
pay for, and massive bills for equipment they use
every day to save patients. However, when your life
is at stake....LOCATION, LOCATION, LOCATION has
never been more important. Think about this...
there are over 125 different types and sub-types of
cancer. Is it reasonable to believe that every hospital
or treatment facility (especially in rural areas with
minimal staff) can treat every one of those cancers?
2) Experience bias: They saved my life before.
While this sounds reasonable, be careful unless they
treated you a few years before for the same illness.
When our friend Randy found out that he needed
heart valve replacement surgery, he chose a local
facility that had saved him after a serious accident
25 years before. He felt he could trust them with
his life. A pig heart valve was used to replace his
defective aortic valve. Everything seemed to be
fine for a few months, but then Randy fell gravely
ill with an infection (endocarditis) that ended up
taking his life. After being transported to a leading
medical facility in another state, the specialists
there expressed concern about the quality of the
operation. Although a definitive analysis was never
done, Randy's grieving widow believes that several
key aspects of the healthcare system failed:
An inadequately experienced surgical staff
Lack of antibiotics as part of post-operative
home care; and
Lack of sufficient follow-up in the months after
the surgery.
BIAS FROM THE DOCTOR'S VIEWPOINT:
1) In Network / In Hospital Bias: Choosing a referral
practitioner for the patient based on doctor's in
the same network or hospital system--as opposed
to the best choice based on qualifications.
"The biggest phenomenon in our country is the
proliferation of narrow networks, including networks
that own doctors' practices. So we have more and
more doctors giving up private practice, and selling
out even to a large multi-specialty group, a single
specialty group or to a hospital that controls dozens,
hundreds or even thousands of doctors. If you're part
of a group that either pays your salary, or in which you
have an ownership share, you may have compelling
institutional, managerial or even financial reasons
to refer inside the group." ~ Alan Sager, Professor of
Health Law, Boston University