Great post Dr Prasad! In addition to following sometimes statistically dubious guidelines to administer chemotherapy, is there another disincentive looming, which is to diminish the risk of litigation? I can imagine a prosecutor telling a jury that a physician did not follow recommended drug protocols and the jury just buys that line of reasoning...
Endorse your comment that we're willing to spend money on marginally useful drugs but not allied health or social services which if you asked the patient, they would rather have. We currently have a young patient with PNES (FND) who ED admitted for functional seizures, she's been inpatient for 5 days, waiting for an MRI (why? because the family wanted one, the PNES diagnosis is established) - we have no treatment to offer her, she'll still get discharged after the MRI, and if she'd been an outpatient that hospital stay would have funded 3-6 months of intensive outpatient therapy (psychology and physio) actually treating her FND, but because we don't fund allied health but we do fund inpatient stays... She gets a pointless hospital admission. Ok, it validates her sense that she's sick, but if we were transparent with her about the fact that she doesn't need to be in hospital, and that funding unnecessary hospital admissions contributes to our inability to fund necessary outpatient allied health, I think she'd consider therapy if it was the alternative to hospitalization. This is in a publically funded healthcare system. As a mature medical student, I'm gobsmacked by the people we keep in hospital unnecessarily... In a hospital system that isn't coping.
Thank you Prasad. Always interesting to listen to you. When you are 70+ you sometimes think of the coming years. Care is very important. Sorry to say I have, after Covid lost some trust in big pharma.
My partner says i may work in combination. _JC
Great post Dr Prasad! In addition to following sometimes statistically dubious guidelines to administer chemotherapy, is there another disincentive looming, which is to diminish the risk of litigation? I can imagine a prosecutor telling a jury that a physician did not follow recommended drug protocols and the jury just buys that line of reasoning...
Endorse your comment that we're willing to spend money on marginally useful drugs but not allied health or social services which if you asked the patient, they would rather have. We currently have a young patient with PNES (FND) who ED admitted for functional seizures, she's been inpatient for 5 days, waiting for an MRI (why? because the family wanted one, the PNES diagnosis is established) - we have no treatment to offer her, she'll still get discharged after the MRI, and if she'd been an outpatient that hospital stay would have funded 3-6 months of intensive outpatient therapy (psychology and physio) actually treating her FND, but because we don't fund allied health but we do fund inpatient stays... She gets a pointless hospital admission. Ok, it validates her sense that she's sick, but if we were transparent with her about the fact that she doesn't need to be in hospital, and that funding unnecessary hospital admissions contributes to our inability to fund necessary outpatient allied health, I think she'd consider therapy if it was the alternative to hospitalization. This is in a publically funded healthcare system. As a mature medical student, I'm gobsmacked by the people we keep in hospital unnecessarily... In a hospital system that isn't coping.
Thank you Prasad. Always interesting to listen to you. When you are 70+ you sometimes think of the coming years. Care is very important. Sorry to say I have, after Covid lost some trust in big pharma.