Bioethics Discussion Blog: A Truism in the Practice of Medicine: THINK SIMPLE

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Friday, March 31, 2006

A Truism in the Practice of Medicine: THINK SIMPLE

Jerry went to a psychiatrist. "Doc," he said, "I've got trouble. Every time I
get into bed, I think there's somebody under it ... I'm going crazy!"

"Just put yourself in my hands for one year," said the shrink. "Come to me
three times a week, and I'll cure your fears."

"How much do you charge?"

"A hundred dollars per visit."

"I'll have to think about that," said Jerry.

Six months later the doctor met Jerry on the street . "Why didn't you ever
come to see me again?" asked the psychiatrist.

"For a hundred bucks a visit? A bartender cured me for $10."

"Is that so? How?"

"He told me to cut the legs off the bed! Ain't nobody under there now!!!"

There is a truism about the practice of medical diagnosis and treatment in that amusing story. There is often a simple explanation for a complex combination of symptoms with which the patient is presenting. It is the sign of a thinking physician to find that explanation. The medical workup for a disease also can be simplified. Just because techniques such as expensive CAT scans or MRIs, as examples, are available, ordering these may not substitute for appropriate testing with less expensive and less invasive approaches. Often, many various testing methods are used which are unnecessary because it is easier for the physician to write the orders for these tests than to take time to THINK. And the issue of thinking simple can be applied to medication and prescription writing. Is that more expensive drug (usually the newer drug) or drug which requires more patient attention to be compliant with the directions really necessary to prescribe or could a less expensive drug or one to be taken once a day be equally as effective or in the case of compliance issues (cost or dosing schedules) even more effective? Why is thinking simple important? The simple diagnosis is often the more common. The simple workup is often the less expensive and the least harmful for the patient, especially if invasive testing is being ordered. The prescription of treatment which is not being influenced by pharmaceutical company pressures to use their newer and more expensive drugs or procedures more to enhance the physician’s pocketbook, all will make medical care less a financial hardship and lead to better care for all patient groups. I don’t want anyone to think that the effective practice of medicine is always simple. It isn’t. But doctors must learn when they are diagnosing and treating their patients to STOP A MOMENT, TAKE A DEEP BREATH and just consider to THINK SIMPLE. ..Maurice.

1 Comments:

At Saturday, April 29, 2006 12:37:00 PM, Blogger in-limbo said...

An old friend of mine once told me that she was trained "when you hear hoof beats think horses not zebras".

That's great advice unless you're a zebra (which I have proven to be in more examples than I can remember).

The latest is finding out that I am without communicating arteries in my brain circulation. I have a totally incomplete circle of willis (which is sort of an oxymoron). Evidently this is congenital

 

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