Friday, October 26, 2012

YGBEHR: What measurable benefits will you deliver?

Your Great Big Expensive Healthcare Reform: What measurable benefits will you deliver?
Part 1 of 4
Introduction - Background and questions

[625 wds]

Government reform in healthcare is predicated on patients moving into a space that involves taking responsibility for their own treatment.

For this to properly occur, all health professionals have to engage with their patients and begin to mentor them to assist in understanding their health problems.
They must provide education and resources so that this process can occur.

To an extent this has successfully occurred, but only in the complementary and alternate medicine field, which is rapidly expanding compared to the mainstream medical model, albeit off a very low base so absolute numbers are still small.

Patients are voting with their feet, because with a CAM or Integrative Medicine Practitioner, a patient can be treated wholistically, in an often friendlier and more caring environment, with mentoring as the primary method of engagement.

This enables a patient to be given sufficient education to understand and research (usually by the Internet) their own medical issues and develop their own list of talking points to engage their doctor or other health professional in discussion and education.

If that process is done correctly, patient damage and misadventure would be minimised and mutual confidence, communication and respect be built.

The reality is that doctors are on record in their journals and publications stating that they hate and refuse to deal with patient “lists”. They insist that an appointment be made for each separate item on a list.

“Mentoring mode “ patient engagement does not, even cannot, happen within the strict time constraints of GP clinics.

As the engaged patient battles to address the balance of power in the doctor/patient relationship, organisations to shore up both sides of the equation have developed e.g Consumer Health Forum (CHF); Friends of Science in Medicine (FSM).

It is FSM that is proposing a “great big expensive reform” quintessentially disruptive, on a global scale, to all healthcare professions by insisting on the innocent sounding formula of (only) “Science based Medicine”.

The Institute of Science in Medicine (ISM) is the American/Global model from which FSM is cloned. ISM are advocating a rather extreme version of Healthcare reform:

    The Medicalisation of all Healthcare, under the cover of more "Science in Medicine".

These extreme views are published in an ISM Policy paper on the Licensing of non-Medical Healthcare practitioners [1]. They advocate changing world-wide statutes/regulation to only allow "science-based" Healthcare (code for Only Medical Care) and finish with:

   Unscientific practices in health care should further be targets of aggressive prosecution by regulatory authorities. [italics added]

They don't just want to wind the clock back to The Grand Old Days of the Fifties, but a whole Century. The authority they cite is the 1910 Carnegie Foundation report on Medical Education by Flexner.

Flexner tossed around many concepts, many more than the State Regulation of Medicine and Medical Schools on which ISM/FSM base their calls for increased Healthcare Regulation, or "Science in Medicine", as the definitive solution to all the ills of all Healthcare Systems in all the world.

In a later article in this series, Flexner's original thesis and concepts are examined - and not wholly surprisingly they support the opposite position of ISM/FSM.

Firstly, What do the world's best experts in Healthcare Reform identify as the local and/or common challenges to Healthcare globally

How do the proposals of ISM/FSM address these Millennium Medical Problems?

Most importantly, by insisting on “Good Science” from others, they are setting themselves up to be exemplars in how its done. ISM/FSM must first provide us with irrefutable Scientific Evidence of the benefits their Big Expensive Reforms will deliver, not just spout ideology or wave their hands about saying “it’s obvious”.

We are talking about fundamental changes to a Multi-Trillion Dollar Global Industry. Nobody will touch it unless there is the highest grade Evidence and demonstrated, quantifiable benefits, Financial and in Health outcomes for Individuals and Public Health.

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