Saturday, July 18, 2009

Patients First: Twitter Transcript

From the first tweet by Dr. Val...


Medbloggers and congressman discuss healthcare reform at the National Press Club today 9am-12pm ET. Follow #patientsfirst for live coverage.

....to the multitude of tweets from participants and the audience, it was an intense and vibrant conversation. The tweets of those on Twitter were in the background as those on the panel gave their responses.

I missed it. I was working and couldn't watch. But I wanted to read the thread as it happened, in the order it happened. So I compiled it and here it is for those of you who missed it or want to read what others had to say.

To those who participated and/or tweeted, I want to say a great big "THANK YOU!!"






UPDATE: Here are some blog posts/links that are pertinent to this discussion. Feel free to email or comment below if there are others which I've missed:

Someone who actually knows how to put patients first

Congressman Paul Ryan's speech

Media piece about Patient's First

Dr. Rob's post about his experience

Dr. Wes' speech

Dr.Wes' wrap-up

1 comment:

  1. I appreciated the comments of Dr. Rob.

    But I was disappointed in the exchange overall. IMO,while there may be some overlap, the debate on funding of health care and the discussion of improving medical care and the doctor patient relationship are very different discussions. Unless doctors are saying that they are just pure mercenaries (in which case they are not professionals), efforts to improve care should not depend 100% on how doctors get paid.

    I wanted to hear how the medical profession can improve care and have a more patient centered process. That is not 100% dependent on the payment process.

    The reason why I liked Dr. Rob's comments is that he indicated the patient is the pinata in this process. This is true. In any effort, there is a trade-off between cost, schedule and risk. None of those three factors are fixed -- they all can be managed, but you cannot optimize all at the same time. Insurance companies care about cost, as do patients where they bear part of the cost. Patients bear the risk of both improper lack of treatment and the wrong treatment, and doctors have a bigger exposure to erroneous treatment and therefore try to avoid that as much as possible, at the expense of cost and schedule and possible opportunities for cure. Only the patient really cares about schedule. This is why in the british and canadian system, there are waits. and more waits. The patients have no voice. If you want to optimize patient care within the constraints of cost, schedule and risk, patients need to be the final arbiter for treatment options, and need to bear enough of the cost of health care that they incentivized to consider cost and have enough control of the purse strings to affect physician behavior -- for example, having patients have input on 10% of PC and 20% of specialist reimbursement. That is how you align the interests to get a well-functioning health care system - and for that, a government funded plan is not going to work.

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