Monday, November 3, 2014
What is the most healing quality a physician can offer a patient or society?
How can a physician be an activist in his or her patient's healing? Can that same physician be an activist in society's healing? Joining host Dr. Martin Samuels is Nobel Peace Prize recipient, noted cardiologist and author Dr. Bernard Lown. Among other topics, they discuss how time is critical in understanding the ailments of the patient, and individual physician's responsibility to society.
"Dr. Martin Samuels: Time is a big issue for people. A lot of people listen to this program feel like they are being forced to see people in 15 minutes. What do you think that does to medicine?
Dr. Bernard Lown: I believe that the critical issue in medicine today is time. Because time is the factor that accounts for high cost of health care - an absence of time. The moment that the doctor doesn't have time, he treats the chief complaint. I mean the patient comes in and says he has an ache in his left shoulder. Frequently, you find that that is merely an admission ticket. Once you talk with them and take time, you learn that the shoulder is not bothering them, what is bothering them is the fact that they hate their job, they haven't got a good martial relationship, their son is misbehaving ... any number of problems. And the moment you begin to take time, you do not [need to] refer them to other specialists [or for expensive testing]."
Bernard Lown, MD
Nobel Prize recipient Dr. Bernard Lown is professor emeritus of cardiology at the Harvard School of Public Health, senior physician at Brigham and Women's Hospital, and the chairman and founder of the Lown Cardiovascular Center and Lown Cardiovascular Research Foundation.
A pioneer in rearch on sudden cardiac death, Dr. Lown invented the direct current defibrillator for resuscitating the arrested heart as well as the cardioverter for correcting disordered heart rhythms. He also introduced the use of the drug Lidocaine for the control of disturbances of the heartbeat.
Dr. Lown has long been an activist to abolish nuclear weapons and promote world peace. In 1962, he co-founded the Physicians for Social Responsibility and became its first president. In 1980, he co-founded with Russian physician Dr. Yevgeny Chazof the International Physicians for the Prevention of Nuclear War, and were co-recipients of the Nobel Peace Prize on behalf of IPPNW.
Dr. Lown has also authored or co-authored over 400 research articles and four books related to healing. His latest is Presciption for Survival.
Affiliations: Harvard School of Public Health, Brigham and Women's Hospital, International Physicians for the Prevention of Nuclear War
What can patients do about doctors that can't spend enough time with them due to demands from insurance companies or their employers? Physician time should be treated like gasoline for your car. If you need to drive more, then you need to set aside more money for that predictable cost. Physician time is one of the most inexpensive parts of our health care system - why then can't we (as discerning consumers) set aside money for this time. Instead we continue to pump increasing amounts of money into what was originally designed for catastrophic events to cover this everyday costs. This allows for diversion of YOUR money into non-health-promoting tasks like prior authorizations, EMR mandates and updates, billing compliance, and care utilization reviews. Do we expect our car insurance to cover the gasoline for our car? As a consumer, demand from your health insurance company a policy with the flexibility to pay for the time that you want with your physician (or else find another policy or a physician that doesn't deal with insurance companies). Insurance locks both YOU and the PHYSICIAN into a contract that prevents us from individualizing the time of a physician visit. Physicians are prohibited (when we accept insurance in the clinic) from working out an individualized "time" and "price" for our intellectual service that both the patient and physician think would be helpful or appropriate. Instead, everyone is forced to fit into a one-size fits all 15 minute visit.