Friday, October 26, 2012

YGBEHR: Conclusion - adhere to the same standards you set for others

Your Great Big Expensive Healthcare Reform: What measurable benefits will you deliver?

Part 4 of 4

[800 wds]

Free Speech is enshrined in Black-letter or Common Law in every Western Democracy, even in the Bill of Rights where extant.: one of our most precious Freedoms. But you don’t have the freedom to shout "Fire!" in a crowded place nor abuse anyone at anytime.

All Democracies have a tension between allowing robust conversations between citizens and silencing those whose agenda is anti-Democratic: mendacious, destructive, abusive or outright cranks and nutters. In the law, they are vexatious litigants.

 On the Internet, they’re called “Trolls”. [1] People whose sole purpose is to create mischief, turmoil and upset, not furthering debate or arriving at a consensus.

From my research for this piece, I can only conclude that FSM and their American parent, ISM, are Medical Trolls.
They mean no well, exist only to criticise, destroy and  intentional create mischief and spread dissension.

The test is quite simple: What are the positive elements of their Demands or Proposals?
None that I can make out in their published statements.

Importantly, where is the Patient in all the ISM/FSM doctrine? If Medicine isn’t being done for the Patient, then why is it being practiced?

Are FSM a Cult? A sub-sect of their extremist funders, The Skeptics?
They have a clearly identifiable target group, Creed, Catechism, Holy Tracts, Prophets, Disciples and, of course, the Great Leader whose Word is Truth. All the elements are there, even if they don’t yet self-identify as such.

To say both ISM and FSM publications are biased, one-eyed and prejudiced is an understatement. Their motives, methods and means aren’t just opaque, but often vague and chaotic. Their idea of “evidence” seems to be dogmatic assertion and endless recitation of their Catechism and quoting of The Holy Tracts. They ignore the rules of logic, ignore or change inconvenient facts and seldom cite solid facts, not mere opinion and assertion.

Something that struck me researching this piece is the fragility of everything that ISM/FSM publish or rely upon. My surprise was nothing I looked at was as they said. It isn’t just that their “research” and “evidence” is confined to their circle, rapidly becoming self-referential, but even modest research turns up significant holes or contradictory evidence.

Such as their prime authority, the Flexner Report. Just thinking that a century old opinion piece that was a front for an AMA, power-play written in florid, even derogatory, language by a non-medical person would be relevant after a century of rapid change and increase in all Human Knowledge is incredible. More so that the Carnegie Foundation produced a current and very different report in 2010, which they ignore.

Then I read the Flexner report and it says so much more, including a very powerful principle that is followed in Aviation: for all licenses to be equal value, frequent practitioner knowledge and competency testing is mandatory. But few of the ISM/FSM folk seem to have read their own prime authority. Strange.

Go to any country in the world, and their Healthcare systems are under stress, all grappling with similar problems: too few practitioners, access to good care, Quality of Care, Patient Safety and Affordability.

 The ISM/FSM agenda seems to be strictly anti-Alternative Therapies and Medicine Can Do No Wrong. If they achieved their best outcome how would it affect the problems being experience globally?

It pushes everything in the wrong direction!

There would be more patients in the Medical system, Quality of Care and Patient Safety would decline due to increased loads and practitioner stress and cost to patients can only increase because of the Economics fundamental: Higher Demand and lower Supply leads to Higher Prices.

Even if you only peel back one level, the ISM/FSM scheme is suspect. At best they would displace just 1% of total Healthcare costs by quashing all Alternative Therapies.

This is worse than irrelevant when the known Best Practices yield 20-30% improvements in costs plus improving Patient Safety and Quality of Care: areas never covered by ISM/FSM.

This is the approach taken by the leaders in the Healthcare Reform field: Institute of Medicine, TMIT and the best institutions.

A necessary part of the solution to improving Healthcare in the age of the Internet is to engage health consumers, the Patient. To mentor them in improving their own care and preventing illness.

Lastly, if the ISM/FSM message was powerful and compelling, they would have a high-profile within their Professional Associations. This isn’t so, they are shunned by the people who know Medicine from the inside out.

What are retired Academics and Medical Practitioners thinking when they invade a well established field without acquainting themselves with the leading practitioners and best research? It isn’t Good Science.

Which neatly summarises the problem: The people who are calling for Good Science, themselves don’t practice it. Which isn’t irony, it’s ignorance and hypocrisy.

[1] Trolls

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