Blink and Blogs

How much information does it take to make a decision? Is it possible that we gather too much information before we move ahead? How many tests can doctors order before a diagnosis is made? Will it be too late by then? We find ourselves in the Catch-22 of waiting for availability for the tests, waiting for the results, waiting for a decision to be made about what type of treatment is needed, and then waiting for availability for time for the treatment. There are too many patients and too few doctors. So tests are ordered to buy time. The clinical judgment gets skewed because we start to rely more on the tests than our clinical skills. The reimbursement keeps decreasing as insurance companies try to squeeze out every last penny from the doctors and the collection tactics for those that have private insurance become ever more unscrupulous. The best and the brightest, who once migrated into medicine, are now joining the corporate sector or technology where they can make more money with fewer hassles. How do we encourage our children to go into medicine where they will incur huge debt, long hours, and more headaches. The liberal left promotes universal healthcare, but don't look at the failures of those systems, or the fact that in the European countries, physicians either have little or no tuition, and thus little or no debt coming out of medical school. We could all be more altruistic if that were the case here. As we know, it isn't.
So we need to find more efficient ways to practice medicine like the example in Malcolm Gladwell's book, Blink, another great book by the author of The Tipping Point, in which he describes the protocol followed by the emergency department at Cook County Hospital for possible heart attack victims. Another possibility is to have greater access to online medicine, where the experts in a given field are available through Blogs or another dynamic forum. It is happening slowly, but too many physicians are leaving the field and it is especially notable in rural areas, where the reimbursement is lower, the risk of malpractice continues to be great and the income does not always pay the rent. We are in need of a paradigm shift in medicine. Right now, there continues to be more questions than answers and America is getting sicker.