Big data is here and will probably stay. While some of it is good, much of it turns patients into quantifiable bits of data. Patients are people. They are not diagnoses, data, clinical outcomes, metrics, or numbers. All too often those working in the healthcare industry forget that fact. The insurance industry pushes us to report metrics and clinical outcomes. Sure, better numbers probably indicate that the patient is better off, but we should never forget the person in the patient. And while some suggest that big data improves clinical outcomes, the simple truth is that there is big money in big data.
Why is there this trend to dehumanize patients?
- Insurance companies want to quantify patients’ medical condition to determine reimbursements. This is simply a cost-cutting strategy by third parties.
- The ACA (Affordable Care Act) changed patients into consumers. Patients should control what happens to their own health. But being defined the same as a customer shopping at the local Wal-Mart takes the real person out of the patient. Doctors are there to give the patients are best medical advice. We are not customer service agents who need to make them happy all the time. Happiness is never guaranteed in medicine. If it were, we would never see patients with cancer or other terrible diseases.
- As a doctor in training, I remember learning that we should never refer to patients by their disease state (e.g., the diabetic in room 3). It often is easier to refer to a patient as such when they are fighting a terrible disease rather than personalizing them by calling the patient by name. But as doctors, we are called to do this hard thing. We need to keep the person in the forefront and deal with them on a personal basis. This is true medical care.
- Many patient advocate groups take the “us vs. them” line of thinking too far. They want to be seen as the consumers who drive all decisions, with doctors there to serve their needs. I agree that patients need to be advocates for their own health, and there are many doctors out there who are overly paternalistic. But unless doctors and patients work together as a team, the humanity in the relationship gets lost.
Patients are real people and doctors are too. We need to remember the humanity of each. Every patient is different and requires individual and personalized attention. To just stick them on a clinical pathway and expect them to follow a specified course to achieve a designated clinical outcome is wrong. Every single patient needs to be evaluated as the unique person they are. And patients need to remember the humanity in doctors as well. We are not diagnostic robots and we are not machines that can spit out medical information 24/7.
Only when we respect each other’s humanity can we develop real therapeutic relationships. I need to care about a person, not a predetermined number such as a cholesterol level. Medical decisions require communication between doctors and patients, not dictatorial decisions from third parties.
FROM “The Healthcare Apocalypse”
© 2016, Linda Girgis MD. All rights reserved.