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>then they can follow along those delivering the care. I don't doubt your intent is good, and I like to promote literacy in care as well, but I really really t

>then they can follow along those delivering the care. I don't doubt your intent is good, and I like to promote literacy in care as well, but I really really think the notion that supervising one's own care is a good idea is completely out to lunch. The pain, discomfort, emotional trauma, precarity -- these very real things tend to put even the best manager off one's game.

DanBC 10y ago
Medical error doesn't just happen in emergency care. One of the most important questions you can ask your doctor before getting treatment (whether that treatment is surgery or medication) is "What happens if we don't do anything? If we just watch and wait?" Here's a short film about involving older people, and their carers, in their healthcare when they enter a carehome setting. This work focusses on a medication review involving a doctor, a pharmacist, the patient, and their carers. The reviews save money, increase quality of life, and reduce risk of death by suicide and accidental death. http://www.health.org.uk/pills http://www.health.org.uk/pills
- harrumph 10y ago
  Thanks for this. I'd say these are reviews taking place in a clinical setting and geared toward generating a care plan with a time frame of some length. Under these conditions, we could expect a patient to be laboring under the fewest possible distractions and as such be the best candidate for supervising one's own care. But it is seriously wrong to assume the patient will continue to act akin to a corporate employee bloodlessly toiling on a project at work. It is far more likely that the patient will at some point begin to act like a person with discomfort, with all the accompanying bewilderment, skepticism, confusion, hypersensitivity, etc. This reality needs to be honored, not waved away. Again, I do advocate for educated and engaged patients, but I totally reject the idea that systematically these patients are to be depended upon for engagement in their own care to the degree that any medical errors can reasonably be precluded by such engagement. Not only does it fly in the face of psychological realities of patients, it appears to me to be an ugly slippery slope toward the direction of general victim-blaming and "externalization" that the corporate ethos is so well known for.
  - flarg 10y ago
    My own experience has been that engaged patients get the best outcomes and that healthcare is so complex that only the patient can really control what is going on. This is no different from my clients in technology consulting - only the truly engaged clients get what they want.
harrumph 10y ago
Wow. These downvotes aren't doing a damn thing to contradict the popular notion of tech workers as brutally lacking in human empathy.
- devin 10y ago
  2¢: I wouldn't take it that way. I upvoted your comment. There are a couple of things you ought to consider when reading the replies. 1.) People want to believe that they'll know when they're "off their game". That doesn't make them brutalist thugs. There's plenty of cognitive bias to go around. 2.) Saying it is "out to lunch" to manage one's own care is lacking in the context department. It seems to me that there are plenty of situations where the patient is in a strong position to "manage" their own care. Is that always the case? Certainly not, but it's not patently false. It depends. There's been talk in the comments on this story about modern aviation, copilots. The relationship between a patient and provider ought to be adjusted to find the best outcome. Finding the right mix is difficult, but I think we can do better than "The patient is always right" or "The provider has absolute control."
athenot 10y ago
That's why I mentionned that having a trusted friend/relative to go in with the patient is preferable.
- logfromblammo 10y ago
  Even if your trustee doesn't know anything about medicine, frequent demands for hospital staff to "wash your hands before touching the patient" and "explain to me what you're doing now" still let the staff know that making a mistake with this particular patient could be costlier than with another patient. I hypothesize that fewer avoidable mistakes will be made, due to care-providers exercising more caution while under the strict scrutiny of your trustee. If they know anything at all about medicine, the outcome is likely to be even better.

DanBC 10y ago

Medical error doesn't just happen in emergency care. One of the most important questions you can ask your doctor before getting treatment (whether that treatment is surgery or medication) is "What happens if we don't do anything? If we just watch and wait?" Here's a short film about involving older people, and their carers, in their healthcare when they enter a carehome setting. This work focusses on a medication review involving a doctor, a pharmacist, the patient, and their carers. The reviews save money, increase quality of life, and reduce risk of death by suicide and accidental death. http://www.health.org.uk/pills http://www.health.org.uk/pills

harrumph 10y ago
Thanks for this. I'd say these are reviews taking place in a clinical setting and geared toward generating a care plan with a time frame of some length. Under these conditions, we could expect a patient to be laboring under the fewest possible distractions and as such be the best candidate for supervising one's own care. But it is seriously wrong to assume the patient will continue to act akin to a corporate employee bloodlessly toiling on a project at work. It is far more likely that the patient will at some point begin to act like a person with discomfort, with all the accompanying bewilderment, skepticism, confusion, hypersensitivity, etc. This reality needs to be honored, not waved away. Again, I do advocate for educated and engaged patients, but I totally reject the idea that systematically these patients are to be depended upon for engagement in their own care to the degree that any medical errors can reasonably be precluded by such engagement. Not only does it fly in the face of psychological realities of patients, it appears to me to be an ugly slippery slope toward the direction of general victim-blaming and "externalization" that the corporate ethos is so well known for.
- flarg 10y ago
  My own experience has been that engaged patients get the best outcomes and that healthcare is so complex that only the patient can really control what is going on. This is no different from my clients in technology consulting - only the truly engaged clients get what they want.

harrumph 10y ago

Wow. These downvotes aren't doing a damn thing to contradict the popular notion of tech workers as brutally lacking in human empathy.

devin 10y ago
2¢: I wouldn't take it that way. I upvoted your comment. There are a couple of things you ought to consider when reading the replies. 1.) People want to believe that they'll know when they're "off their game". That doesn't make them brutalist thugs. There's plenty of cognitive bias to go around. 2.) Saying it is "out to lunch" to manage one's own care is lacking in the context department. It seems to me that there are plenty of situations where the patient is in a strong position to "manage" their own care. Is that always the case? Certainly not, but it's not patently false. It depends. There's been talk in the comments on this story about modern aviation, copilots. The relationship between a patient and provider ought to be adjusted to find the best outcome. Finding the right mix is difficult, but I think we can do better than "The patient is always right" or "The provider has absolute control."

athenot 10y ago

That's why I mentionned that having a trusted friend/relative to go in with the patient is preferable.

logfromblammo 10y ago
Even if your trustee doesn't know anything about medicine, frequent demands for hospital staff to "wash your hands before touching the patient" and "explain to me what you're doing now" still let the staff know that making a mistake with this particular patient could be costlier than with another patient. I hypothesize that fewer avoidable mistakes will be made, due to care-providers exercising more caution while under the strict scrutiny of your trustee. If they know anything at all about medicine, the outcome is likely to be even better.