Why are Americans Unhappy with Doctors and Pharmaceutical Companies?

Dissatisfaction with health care seems to be taken as a given these days, with Sicko (which I have not seen yet) as a seminal example. Glenn Reynolds has presented strong arguments in favor of not taking how good we actually have it for granted, both from personal experience and as a commentator. In addition, he has done good work presenting views opposing nationalized health care and pointing out the hypocrisy of those who support it.

I am now deeply concerned about the potential for nationalized health care. In my family, we have lived with conditions that are persistent, but are not easy to treat or diagnose. As a result, we have been through a lot of expensive tests, nights at the hospital, and a lot of prescriptions. Through all this, we have had little trouble with our insurance. In fact, I'm sure we've exceeded our paycheck co-pay almost every year. Under a nationalized health system, I'm not sure things would have a gone as a smoothly (at least as far as getting timely access to tests and getting covered by insurance for these tests).

But, I think this experience has also highlighted some of the troubles with the health care system. We have had some great, caring doctors, but we have also had some arrogant, demeaning doctors. In fact, one doctor refused to recognize symptoms we had brought to him regarding one of our conditions. In the end, we later discovered that there was significant literature out there on these symptoms. The doctor either was unaware of this literature or refused to inform us that it was out there. Either way, I am still deeply frustrated about that situation.

As far as pharmaceuticals, I think doctors share some of the blame for the discontent with "Big Pharma." Just as anti-biotics may have been over-prescribed, I think drugs are sometimes prescribed or continue to be prescribed when they are obviously not effective. In our case, we have moved from one drug to another and been told that it is unlikely statistically that any will work, yet the doctors insist that that they still be part of the treatment. I wonder sometimes if doctors are protecting themselves (from potential future litigation) or are afraid to abandon the consensus treatment. I imagine that our case is not unique. While drug companies are not to blame for this situation, its hard to not be skeptical the next time you receive a prescription.

One helpful equalizer in all this, I think, is the Internet. In some cases, when we have received sketchy information from our doctors, the Web has made up for the holes. It is not easy to find good information, but it's getting easier. Podcasting has been extremely helpful. If you can select good institutions to get information from and make sure you're reading peer reviewed science-based health information. In the future, with health care demand increasing, its unlikely that doctors will have more time to spend with patients. I think that this will require patients to be partners in their care and it is their responsibility to learn what they can about their health.

Another point: Where doctors often run into trouble is treating the conditions they do not have a strong understanding of. The drugs and the treatments are a shot in the dark. I think as time goes on, they will be less and less that is unknown and that the drugs will be more effective and more targeted. So, time may take care of some of the dissatisfaction with health care.

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