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Wednesday, May 19th 2010

Don’t Stay In The Hospital Alone

Atul Gawande has certainly become a prominent public commentator on medicine. Mostly on the quality of health care and how to improve such. I enjoyed Complications and sure I will Better whenever I get around to it (it’s on my Kindle).

Here he is talking about a patient’s responsibility in his or her health care. His advice is a well touted motto: be involved. Ask questions, offer your observations, have family members around to speak up on your behalf.

But as he may admit the problem is huge. It is more than just a social one, a cultural one. True, for most of its life medicine has promoted paternalism and such is ingrained in many physician-patient relationships. But beyond that there is such a monopoly of information in health care.

Often, in complex critical situations, there is so much that cannot be conveyed to the patient in the time afforded them. There are so many times when the understanding of the situation is so far below just the basics, when, no matter the social and communication skills of the providers, it is impossible to even put more than a basic understanding of what is going on to empower the patient and family to even ask appropriate questions.

I’m not arguing for paternalism, just that sometimes the situation is more difficult than the ideal.