Doctor's Hand to Your Mouth

A study paper in the current Journal of the American Medical Association concludes very little. The major finding is that Americans pay twice as much a year for medical care than Brits do. Yet we get shorter, sicker lives.
You can read the abstract of Disease and Disadvantage in the United States and in England (you need a sub or to wait six months for the whole thing). Popular coverage is ubiquitous, including this overview in the International Herald Tribune.
We suggest that they need look no farther than the table where they confer.
They eliminated smoking, weight, alcohol and all the usual bugbears. It must be one really rough day for a medical professional when he can't blame something on obesity, eh?
What they have not mentioned is medical care. We get a lot more and die sooner, sicker. Hmm, what can we learn from this?
One solution is to stay away from doctors. Yet, we are so paranoid that if we do, something terrible will happen very soon. After all, our doctors said so.
It's simple, but not that simple. What the report has not considered are some of the most obvious differences:
- We die the soonest and are the sickest of First World countries.
- We spend far more per capital on health care than our peer nations.
- But, aha, much of that expenditure is prescription drug related.
- It is quick, easy and profitable for a doctor to treat symptoms with drugs rather than diagnose and treat underlying conditions, which may lead to sickness and death.
Surprise. Surprise. Surprise.
Imagine instead if a doctor spent an hour rather than seven minutes dealing with your problem. She would ask about what you eat, your bowel movements, and other symptoms, even those you don't think are related.
In this country, they are wont to use the inane BMI chart instead of evaluating your body and health, which would take time. They don't have the time to do their job. They want churn and turn.
From a capitalist/physician standpoint, real diagnosis and treatment are terribly inefficient. Yet it is what they are supposed to be doing. They are allegedly about keeping people healthy and curing disease. Those almost never come from prescribing the most likely drug for a symptom and hopping to the next billable task.
We can cut 18 different ways to Sunday, but we see clear differences in British, Canadian and Israeli treatment.
When my parents-in-law used to visit, each of them would set up pill, tablet and capsule containers across a window sill. Each needed a whole sill.
My wife was appalled to see the array and asked her mother if they were all necessary. My mother-in-law said she asked her doctor the same question. His response was, "What drug?" and wanted her to pick one (rather than dealing with the larger issue). She pointed to one and asked, "What would happen if I stopped taking that?" He said, "You'd die."
That's not an unusual attitude, even if other doctors are not so paternalistic.
American doctors are in a rut, a drug rut. We contend that it is killing us, fast or slowly.
Note: Cross-posted to Marry in Massachusetts.
KEYWORDS: longevity, health, JAMA, doctors, massmarrier
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