+Bubbles 007 As the video mentioned, Choosing Wisely establishes guidelines for physicians to reduce the occurrence of defensive medicine. Of course, defensive medicine is still common but the guidelines provide an open door to improvement in the healthcare system. The initiative has good intentions but I feel a lot of people are not entirely aware of the program. A program like this is a step in the right direction to maximizing the quality care for patient treatment. Doctors still live in fear of malpractice lawsuits. Physicians are aware of the guidelines that the program contains; however, the fear of malpractice lawsuits still lingers and therefore, defensive medicine still takes place. Likewise, healthcare costs remain high. Overall, I love how the program is attempting to but the patients’ best interest for quality treatment into perspective. This is definitely a step in the right direction from an ethical standpoint.
2:56 made me wince a bit. Maybe CT scans aren't necessary in most of those cases, but when I was 1 year old I got what the doctors thought was a minor head injury after an accident with a kid carrier. The doctors told my parents that a CT scan wasn't necessary, but my mom got a "feeling" about my behavior and insisted. What they found was that they needed to operate right away to keep me from dying (something about blood overtaking my brain, I think). While I can understand where you're coming from, it's hard to listen to this knowing that I'm a statistical outlier and might be considered an acceptable loss under this model.
When I go to see the doctor, I am prescribed or offered to buy medicine for every single symptom that I list to them. I've seen 3 different doctors and they all do the same thing. IF I have a fever and there's a known illness going around the city, they tell me to buy medicine X, but also medicine Z for headache and medicine Y for muscle pain... And I never buy anything else than medicine X. It helps, and all my other symptoms are gone with the fever. I live in Europe.
Oh, I know!! It is really tiresome to tell them over and Over and OVER again that not all my symptoms need yet another Rx!!! Some are side effects from other meds I'm on, but they DON'T want to UNsubscribe anything. I have started just stopping a drug if it gets troublesome. If those nasty side effects stop, I'll try it again, cautiously. If they come back, I'll stop it! I am not going to go in and listen to some lecture about how "rare, or unlikely that side effect is, blah, blah, blah, or say "How do I know it was even the drug, and not something else?", after I had just described How, and Why, I stopped it. Or, I'll get the "Yes but....." "Yes, I see where you're coming from, but....", "I get you, but....." They apparently Don't, because their rebuttal shows they have Not listened to me at all! .🤔🤨🙄😶 They don'.t Listen, they just Prescribe
I agree that there are areas spending needs to be decreased. I see this being an extremely long process and deciding which tests and procedures should be done on certain patients as well as when to conduct them will be a major hurdle. Most of these tests and procedures are done as precautionary measures and even though many cases they are seen as unnecessary, there will always be cases it ends up benefiting the patient. There needs to be a set of guidelines for physicians to follow and stick with in all situations, especially when it comes to government spending.this doesn't mean that patients cannot receive these tests because they can still pay it out of pocket. I feel like this would save a lot of money and enable government health spending to be focused in other areas.
I really really agree with the statement about not inducing labor or performing a caesarean when not necessary. Such a waste of money, and there is so much potential for harm to baby and mother. Those are interventions that should only be made when necessary.
Tyrent Den I imagine his opinion might be along the lines of, 'If the diagnosis is accurate and the treatment is effective, why would anyone be against it?' A more useful/interesting question might be: 'Do you think ADD/ADHD is being over-diagnosed?,' perhaps followed up with 'How should we go about reducing the levels of over-diagnosis?'
"Financial incentives drive behaviour"; was there not a recent healthcare triage video finding that pay for performance resulted in little difference in treatment?
If you want doctors to test and treat appropriately, then you need to remove them from legal liability if they use prudent medicine but there is still bad, even fatal, outcome.
The United States definitely needs to find ways to decrease their spending on health care. Especially since we are the country that spends the most of our budget on health care, yet we do not have the best healthcare system. This definitely is not going to happen over night, it is going to take a lot of time. I do not think the United States should go to universal health care because it would cause complete chaos and a lot of back and fourth arguments between political parties, however I do think they should make decisions on which tests/procedures should be done to patients. I feel this also would cause a lot of obstacles, but would be easier to achieve than universal healthcare. Instead of hospitals and doctors setting these policies, I think the government should. If the government regulates these policies there will be no confusion between hospitals, or between hospitals and insurance companies. If patients do not meet the guidelines, but still want a certain procedure done they should either pay out of pocket or be able to make a case to there insurance company stating why they need the procedure. I feel they should still be able to get procedures done if they can find a doctor who agrees that the procedure is safe or willing to do it because people still have the rights to there bodies.
Why hasn't IBM Watson taken over yet. These useless tests would not be allowed by IBM Watson. Tests that matter like ones involving portals and companion cubes would be its focus.
You are doing an extremely important job, unfortunately, it's exactly how you said, it's all about incentives. Doctors want to prescribe easy treatments that will make several patients happy, and satisfied. Doing a complex treatment on sinusitis or simply not treating it at all, would make a single doctor look like a fool while the other doctors offer "better", simpler and easier treatments. Unless this became an actual norm or got somehow regulated by law, this is hardly going to happen on it's own.
@@jnzkngs Actually I am a chiropractor and have practiced this way for years. The problem is when you get a patient that feels they need an x-ray or MRI to "to know what is going on".
I found this interesting until I found the link and read what they had to say about testing for and treating Lyme disease. Their recommendation there is the complete opposite of what should happen. If anything we need better testing for Lyme. If I would have been tested sooner, I wouldn't have chronic Lyme disease and would have my life back. The only thing that's gotten me even close to better is a doctor who treats chronic Lyme disease aggressively with long-term antibiotics and other meds. It's things like this that are driven by the politics of Lyme disease that terrify me that some day I won't be able to get the treatment I need to stay alive. But if it save the healthcare system money, it must be ok then.
Sarah Mabry Unless you have a study to prove your point, their recommendation, however counter-intuitive, accounts for NNT and NNH. In short, they did risk analysis and determined that you're wrong.
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I am thoroughly pleased with the concept of "Choose Wisely" and support its efforts to increase the quality of effective treatment.
+Bubbles 007
As the video mentioned, Choosing Wisely establishes guidelines for physicians to reduce the occurrence of defensive medicine. Of course, defensive medicine is still common but the guidelines provide an open door to improvement in the healthcare system. The initiative has good intentions but I feel a lot of people are not entirely aware of the program. A program like this is a step in the right direction to
maximizing the quality care for patient treatment. Doctors still live in fear of malpractice lawsuits. Physicians are aware of the guidelines that the program contains; however, the fear of malpractice lawsuits still lingers and therefore, defensive medicine still takes place. Likewise, healthcare costs remain high. Overall, I love how the program is attempting to but the patients’ best interest for quality treatment into perspective. This is definitely a step in the right direction from an ethical standpoint.
2:56 made me wince a bit. Maybe CT scans aren't necessary in most of those cases, but when I was 1 year old I got what the doctors thought was a minor head injury after an accident with a kid carrier. The doctors told my parents that a CT scan wasn't necessary, but my mom got a "feeling" about my behavior and insisted. What they found was that they needed to operate right away to keep me from dying (something about blood overtaking my brain, I think). While I can understand where you're coming from, it's hard to listen to this knowing that I'm a statistical outlier and might be considered an acceptable loss under this model.
Sometimes I miss your videos because the colours you choose for the thumbnails makes me think I've already watched it as I scan my subscriptions.
When I go to see the doctor, I am prescribed or offered to buy medicine for every single symptom that I list to them. I've seen 3 different doctors and they all do the same thing. IF I have a fever and there's a known illness going around the city, they tell me to buy medicine X, but also medicine Z for headache and medicine Y for muscle pain... And I never buy anything else than medicine X. It helps, and all my other symptoms are gone with the fever. I live in Europe.
Oh, I know!! It is really tiresome to tell them over and Over and OVER again that not all my symptoms need yet another Rx!!! Some are side effects from other meds I'm on, but they DON'T want to UNsubscribe anything.
I have started just stopping a drug if it gets troublesome. If those nasty side effects stop, I'll try it again, cautiously. If they come back, I'll stop it! I am not going to go in and listen to some lecture about how "rare, or unlikely that side effect is, blah, blah, blah, or say "How do I know it was even the drug, and not something else?", after I had just described How, and Why, I stopped it. Or, I'll get the "Yes but....." "Yes, I see where you're coming from, but....", "I get you, but....."
They apparently Don't, because their rebuttal shows they have Not listened to me at all!
.🤔🤨🙄😶
They don'.t Listen, they just Prescribe
Just watched a news spot about Choosing Wisely being launched in Australia. Excellent news!
I agree that there are areas spending needs to be decreased. I see this being an extremely long process and deciding which tests and procedures should be done on certain patients as well as when to conduct them will be a major hurdle. Most of these tests and procedures are done as precautionary measures and even though many cases they are seen as unnecessary, there will always be cases it ends up benefiting the patient. There needs to be a set of guidelines for physicians to follow and stick with in all situations, especially when it comes to government spending.this doesn't mean that patients cannot receive these tests because they can still pay it out of pocket. I feel like this would save a lot of money and enable government health spending to be focused in other areas.
Seriously need to tweet this entire channel to the President... Excellent content.
I really really agree with the statement about not inducing labor or performing a caesarean when not necessary. Such a waste of money, and there is so much potential for harm to baby and mother. Those are interventions that should only be made when necessary.
How about pro con on high fructose corn syrup.
When will the next Healthcare Triage LIVE be? I recall there was supposed to be one on April 8.
April 15th
They said it on another video of theirs.
where is the link??
Vaibhav Gupta www.choosingwisely.org/
Doug Wild thanks.
what's your opinion adhd medication for children?
Tyrent Den I imagine his opinion might be along the lines of, 'If the diagnosis is accurate and the treatment is effective, why would anyone be against it?' A more useful/interesting question might be: 'Do you think ADD/ADHD is being over-diagnosed?,' perhaps followed up with 'How should we go about reducing the levels of over-diagnosis?'
Especially with the antibiotics thing, doctors might be pressured by pharmaceutical companies to sell and prescribe certain drugs.
How much could be saved if hospitals didn't gouge patience and insurance for everything from surgery to a box of tissue?
In my first year at university I was prescribed antibiotics for bronchitis, makes me wonder why the doctor did that ^^"
Would you do a show on out of hospital births with regard to health outcomes and costs? Thanks!
"Financial incentives drive behaviour"; was there not a recent healthcare triage video finding that pay for performance resulted in little difference in treatment?
If you want doctors to test and treat appropriately, then you need to remove them from legal liability if they use prudent medicine but there is still bad, even fatal, outcome.
The United States definitely needs to find ways to decrease their spending on health care. Especially since we are the country that spends the most of our budget on health care, yet we do not have the best healthcare system. This definitely is not going to happen over night, it is going to take a lot of time. I do not think the United States should go to universal health care because it would cause complete chaos and a lot of back and fourth arguments between political parties, however I do think they should make decisions on which tests/procedures should be done to patients. I feel this also would cause a lot of obstacles, but would be easier to achieve than universal healthcare. Instead of hospitals and doctors setting these policies, I think the government should. If the government regulates these policies there will be no confusion between hospitals, or between hospitals and insurance companies. If patients do not meet the guidelines, but still want a certain procedure done they should either pay out of pocket or be able to make a case to there insurance company stating why they need the procedure. I feel they should still be able to get procedures done if they can find a doctor who agrees that the procedure is safe or willing to do it because people still have the rights to there bodies.
Why hasn't IBM Watson taken over yet. These useless tests would not be allowed by IBM Watson. Tests that matter like ones involving portals and companion cubes would be its focus.
Um, because it's not ready yet...
so now we have to be our own doctors
You are doing an extremely important job, unfortunately, it's exactly how you said, it's all about incentives. Doctors want to prescribe easy treatments that will make several patients happy, and satisfied. Doing a complex treatment on sinusitis or simply not treating it at all, would make a single doctor look like a fool while the other doctors offer "better", simpler and easier treatments. Unless this became an actual norm or got somehow regulated by law, this is hardly going to happen on it's own.
ambrous: no one can reply to you directly, so if you happen to see this, he already has at least one episode on that.
This isn't anything to do with amorous or his question, but why is it that you can't reply to some comments?
Libya4LY
It's one of the profile settings on those users. They've set their profile to not allow comments on public posts.
All of this just goes into your earler video saying how its hard to change physican behavior.
My Chiropractor says this is bull! ;)
***** Your Chiropractor would know best, I mean they are experts in costly and ineffective treatments after all.
See the winky face emoji at the end of my original comment.
@@jnzkngs Actually I am a chiropractor and have practiced this way for years. The problem is when you get a patient that feels they need an x-ray or MRI to "to know what is going on".
debate deepak chopra
If doctors charged less healthcare would be cheaper. Sure maybe make college free for them
I found this interesting until I found the link and read what they had to say about testing for and treating Lyme disease. Their recommendation there is the complete opposite of what should happen. If anything we need better testing for Lyme. If I would have been tested sooner, I wouldn't have chronic Lyme disease and would have my life back. The only thing that's gotten me even close to better is a doctor who treats chronic Lyme disease aggressively with long-term antibiotics and other meds. It's things like this that are driven by the politics of Lyme disease that terrify me that some day I won't be able to get the treatment I need to stay alive. But if it save the healthcare system money, it must be ok then.
Sarah Mabry Unless you have a study to prove your point, their recommendation, however counter-intuitive, accounts for NNT and NNH. In short, they did risk analysis and determined that you're wrong.
Well the next video on guns and suicide will surely rack up a bunch of comments from the pro-gun lobby.