Darn Verghese, he writes too well. This wonderful WSJ piece touches on patient stories and stories shaping our view of health care reform – When Stories Trump Facts in Health Care
He first focuses on listening to the patient. He echoes thoughts that I had in this piece – Seek first to understand. We still produce physicians who do not have fully developed history taking skills. Sometimes we focus too much on the left brain and not the right brain. We who train physicians should always remember that the best physicians fully develop both hemispheres.
So it is for the health care discussion. While one can make a strong logical argument for health care reform, the debate rides on stories. As I made rounds this morning, I thought about the challenges that we face in caring for patients who fall through the cracks. As a physician, I know those stories … and I care.
I know the problems of the status quo. I have heard the statistics of most people liking their current insurance. I also know the stories of patients fighting the insurance companies. I know the stories of physicians fighting the insurance companies.
As I see the trends in health care, I know that we have rapidly increasing insurance costs. I know that our current insurance system has implicitly discouraged primary care physicians.
I understand the fears concerning government involvement. I am weighing good and evil and see more good from a public option. Part of the current story is to substitute government plan for public option. That story and those semantics typify the problem.
Leaving significant numbers of citizens with no realistic health care option costs everyone significant implicit taxes. Each of these citizens has the right to emergency care and hospitalization. Who do you think covers those costs? We all do with higher insurance premiums.
So listen to all the stories. Try to understand what the stories mean. Try to identify with my asthmatic patient who needed hospital admission because she really cannot afford her inhalers or nebulizer solution. Think about providing first class care to a hospitalized patient and then discharging them to third rate care, because they cannot afford or even find primary care. These stories do not make sense to this observer.
