Comments on: Public Health vs. Medicine http://healthcare-economist.com/2007/09/27/public-health-vs-medicine/ An unbiased look at today's health care issues Tue, 02 Dec 2008 08:57:51 +0000 http://wordpress.org/?v=2.6.5 By: jay http://healthcare-economist.com/2007/09/27/public-health-vs-medicine/#comment-85714 jay Sun, 30 Sep 2007 03:18:08 +0000 http://healthcare-economist.com/2007/09/27/public-health-vs-medicine/#comment-85714 What is meant by a process measure as opposed to an outcome. Is good diabetic, cholesterol, or blood pressure control an outcome or a process measure. Or is death and disability the outcome. If the latter, it will take a long time to come to any conclusion. How well a doctor does on most of the quality measures currently in use probably depends more on the educational level of his average patient than on his skill as a physician. To meet quality measures, the thing to do is to discharge from his practice all patients who can't or won't lose the weight or can't or won't take the amount of medicine necessary. Similar to teachers, for whom it is easy to show good test scores in an affluent suburban school where the students' parents value education and are well-educated themselves. It is much more difficult to do so in a school whose students come from disorganized homes where their educations rank low on the family's to-do list. Neither all medical practices nor all schools are near the mean in terms of the ability of the average member of their clienteles to do what is in his/her own best interest. What is meant by a process measure as opposed to an outcome. Is good diabetic, cholesterol, or blood pressure control an outcome or a process measure. Or is death and disability the outcome. If the latter, it will take a long time to come to any conclusion. How well a doctor does on most of the quality measures currently in use probably depends more on the educational level of his average patient than on his skill as a physician. To meet quality measures, the thing to do is to discharge from his practice all patients who can’t or won’t lose the weight or can’t or won’t take the amount of medicine necessary. Similar to teachers, for whom it is easy to show good test scores in an affluent suburban school where the students’ parents value education and are well-educated themselves. It is much more difficult to do so in a school whose students come from disorganized homes where their educations rank low on the family’s to-do list. Neither all medical practices nor all schools are near the mean in terms of the ability of the average member of their clienteles to do what is in his/her own best interest.

]]> By: jd http://healthcare-economist.com/2007/09/27/public-health-vs-medicine/#comment-85514 jd Fri, 28 Sep 2007 05:34:55 +0000 http://healthcare-economist.com/2007/09/27/public-health-vs-medicine/#comment-85514 It is most important for care givers to stay abreast of trends and statistics that relate to the population in which they practise. Socitey has a changing makeup of ethnicities,ages and conditions.There is a changing set of conditions that are prevalent. The patients ultimately depend on the caregivers knowledge and can benefit or suffer as a result. www.healthfulview.com It is most important for care givers to stay abreast of trends and statistics that relate to the population in which they practise. Socitey has a changing makeup of ethnicities,ages and conditions.There is a changing set of conditions that are prevalent.
The patients ultimately depend on the caregivers knowledge and can benefit or suffer as a result.
http://www.healthfulview.com

]]> By: Zagreus Ammon http://healthcare-economist.com/2007/09/27/public-health-vs-medicine/#comment-85454 Zagreus Ammon Thu, 27 Sep 2007 19:56:44 +0000 http://healthcare-economist.com/2007/09/27/public-health-vs-medicine/#comment-85454 As a teacher of evidence-based medicine to residents, it was sometimes a hard sell. Once I started running a health center, I've realized it's even harder. One message for physicians is that it is not required to practice at the level of the evidence, but to know the level of evidence at which you're practicing. This does not sit well with policy types, managers or folks like Rich. I am concerned that the misapplication of guidelines does not take into account patient priorities or realities. After all, they were not called protocols for a reason. As a teacher of evidence-based medicine to residents, it was sometimes a hard sell. Once I started running a health center, I’ve realized it’s even harder.

One message for physicians is that it is not required to practice at the level of the evidence, but to know the level of evidence at which you’re practicing.

This does not sit well with policy types, managers or folks like Rich.

I am concerned that the misapplication of guidelines does not take into account patient priorities or realities. After all, they were not called protocols for a reason.

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