Despite billions spent on advanced medical technologies, patients and their advocates daily experience an erosion of their rights. Ironically, it may be a result of the very successes of science in medicine.
I saw an interesting press release on EurekAlert out of Indiana University. The PR reported the findings of a study done by researchers from the Indiana University School of Medicine, the Regenstrief Institute and the Richard Roudebush VA Medical Center in Indianapolis. The findings appear in the January 2007 issue of the journal of Medical Care.
What is astonishing about the study is that the findings appear self-evidient, especially for those of us who've worked at the bedside consoling and counseling patients with CHF and their families.
CHF invariably involves "complications" (a euphemism meaning we don't exactly know what all is going on here, but there's lots of organs involved). Patients and their family members are often astounded by how quickly their healthcare "team" grows when their loved one has CHF with "complications".
Here is the success of science in medicine. PCPs refer patients to specialists who rely on subspecialists. Each organ now has its own special doctor, and even parts of organs have their very own specialists. The scientific method is by nature reductionistic with analysis dividing one part from another, seemingly ad infinitum.
Component management inevitably leads to episodic intervention, which causes a fragmentation of care. A fragmentation of care entails a breakdown in communications.
The study concluded that members of the CHF "team" should work together! Active patient involvement during treatment, along with "partnership" among healthcare providers "dramatically" improves quality of care.
We "embedded" laypersons, non-medical professionals who serve patients and their families at the bedside, see daily the toll that "component management" takes on CHF patients and their advocates. In fact, we're usually left to pick up the pieces.
Component management inevitably leads to episodic intervention, which causes a fragmentation of care. A fragmentation of care entails a breakdown in communications. The failure to communicate leaves patients and their family members frustrated and angry, which contributes to less than optimal outcomes.
They are left largely on their own to integrate their own care by piecing together bits of information in an attempt to get a complete picture of how the whole patient is doing. Well, not entirely on their own. . .
Now, along comes a study that proves "team" members ought to do a better job in coordinating their activity and involving CHF patients in their own care! Wow!
If nothing else, the study does demonstrate that we remain in a transitional period in hospital medicine as we learn to adapt and adjust to the successes of science in medicine.
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