I have found this discussion very interesting. I think it is about
caring for patients and about money. Knowing outcome data and making
rational (cost-effective) decisions is vital in medicine. Don't let the
"art" of medicine hide lack of information.
And we should all acknowledge that we currently ration health care - we
do it covertly and cut off whole groups of people instead of disease or
treatment groups - just ask the 41 million or more without health
insurance. So - yes - being cost effective does mean we could use our
money elsewhere if we had an inclusive single-payer system.
On the other hand, why are we experts in Pediatric Emergency Medicine if
not to use our experience. I teach my residents that they have to tap
unless they are 99% positive that the child does not have meningitis.
But those of who see a lot of kids and have a lot of experience may be
that confident when someone else is not - so they may appropriately tap
a child that I would appropriately not tap. It seems to me thats the
"art" of medicine.
David F. Soglin, M.D.
Chairman, Division of Pediatric Emergency Medicine
Cook County Children's Hospital
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