Provider. Consumer. Customer. We use these words every day to describe the healthcare world, but a new article in yesterday's New England Journal of Medicine looks at why these words are not necessarily the type of language to promote.
Describing hospitals as "factories" and patient encounters as "economic transactions," two Beth Israel Deaconess Medical Center physicians write in an article that we are living in an environment of standardized, dare they say, industrialized patient care.
Economists and policy makers propose that "[h]ospitals and clinics should be run like modern factories and archaic terms like doctor, nurse and patient must therefore be replaced with terminology that fits this new order," wrote Dr. Pamela Hartzband, assistant professor of medicine at Harvard Medical School, and Dr. Jerome Groopman, chair of medicine at Harvard Medical School and chief of experimental medicine at the Beth Israel.
The authors argue that the good clinical judgment today is endangered of being replaced by the trendy evidence-based medicine and that healers should have room to offer individual-specific care.
The authors contend that these seemingly benign terms of "providers" and "consumers" are somewhat offensive.
"Recasting their roles as providers who merely implement prefabricated practices diminishes their professionalism," they wrote. "... We believe doctors, nurses and others engaged in care should eschew the use of such terms that demean patients and professionals alike and dangerously neglect the essence of medicine."
An article from California Healthline examines why healthcare professionals and patients are skeptical of evidence-based medicine. In addition to generational differences, healthcare professionals may resist evidence-based medicine, assuming they know best. Like (for a lack of a better term) providers, patients also have doubts that evidence-based care means reduced care. And perhaps most hotly contested, healthcare professionals and patients debate what metrics determine what will be evidence for good care.
No, medicine shouldn't be cookie-cutter, and hospitals shouldn't push out an assembly line of patients to ring up more dollars in the cash register. But with the federal deficit in the trillions and healthcare costs rising, can we afford to experiment with medicine now? It may take the romance of the days of Marcus Welby--or for my generation's analogy, Doogie Howser--but healthcare providers are likely (and encouraged by national initiative programs) to rely on the medicine of years past and what are proven methods for general populations. The reality is hospitals, keeping noble missions in mind, must curb healthcare spending and keep patients healthy at the same time. - Karen (@FierceHealth)