Letter to the Editor: Who should be in control of my health?

With regard to health there are things for which we have some measure of control and things we have no control of. Out of our control are our age, our genetic makeup and unforeseen events that happen to us. Within our control are the health risk factors that we deal with every day. Should I exercise, should I smoke, should I reduce my calorie intake, should I ride my bicycle to work, should I ride my motorcycle to work?  All of these risk factors and their perceived benefits are very personal. What I view as an appropriate risk for a given benefit could be perceived as much too risky for someone else. The key to finding the balancing point in the risk benefit ratio is for each individual to determine what is best for them.

The same is true in healthcare. As a physician my role is a glorified advisor. My role is not to make a patient do or not do anything. I give my best medical advice, and the patient sifts through that advice and determines what would be best for themselves. If I feel the advice is very important or of a critical nature, my role may switch to that of a salesman. But in the end it is up to the patients to decide what is best for them. I don’t think any of us want to live in a system where we have no control over what we feel is best for ourselves.

Unfortunately physician and patient autonomy has been eroding through outside agents involving themselves in the physician patient relationship. Insurance company and government involvement has been growing for years, but outside involvement in the physician patient relationship hit a new realm with the advent of Obamacare. Independent Payment Advisory Board, Accountable Care Organizations, Best Practices, Electronic Medical Records, Meaningful Use of EMRs, etc., all ways of tracking medical care from the top down. Regulating who does what, to whom and for how much, instead of what does the patient want once he is given his options from a trusted advisor.

I left private practice medicine last year because of Obamacare. Not because it was the first time government tried to enter the patient exam room, but because of the draconian way it attacked individualized patient care. The locus of control should be the patient, not a government bureaucrat in a distant city.

Dr. Steven J. Dickter
Birmingham Township

 

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