You know, I wonder sometimes about North American society. Canada and America both do this thing where they hand off responsibility to the state, or some arbitrary authority. When I see this, I have to stop and ask myself, why would no one here do that?
A doctor, with this sign in their car, stopping and doing consultations with needy people on the side of the road would likely be arrested and charged for not meeting some arbitrary requirement that's set by some board somewhere who makes rules for hospitals and doesn't bother to think how it limits the ability to act on real problems. No doctor would consider doing this. It's outside the system, they wouldn't endanger themselves that way, even to do good.
It's strange, because we get to see these exemplars of humanity, but it's always people who have to work under the most extreme of conditions, without proper equipment, without a support team or everything we'd demand for every patient here in North America. None of us, not a damn one of us ever meets our potential as human beings, because nothing demands it of us. We never have to struggle, thus never understand what we are truly capable of.
I’m a physician. I’ve seen this image before. I could never do this because doing so in an official capacity would eventually come back to hurt me. It isn’t about making an incorrect medical decision; though that can happen far more easily without a proper consultation space, medical record to reference, and appropriate physical exam. The bigger reason is that these curbside consults with treatment rendered don’t meet the standards of care set as patient encounters by your insurance (which unfortunately keep me afloat). It would only take one person to have a bad outcome or reaction/complication to a treatment and I would have zero grounds to stand on and loose my license. Then I cannot help anyone.
A common criticism I see of physicians is that we tend to make similar decisions and not “listen” to patients enough. Some of that is fair criticism, but it mostly comes to down to risk aversion. The majority of medical decisions we make come down to probabilities that define treatment algorithms and deviation from that has a higher probability of harm. Now of course we are always able to deviate from evidence based medicine to make decisions, but when we do so that is risk is calculated by offsetting other known variables that minimize risk: thorough history, reliable medical records, thorough examination.
I would absolutely love to be able to practice medicine the way you see in movies: the small town doctor, loved and trusted by the town citizens, informally dispensing advice, unencumbered by laborious insurance billing requirements. In reality, we’d be sued or broke in short order. Almost every television doctor modern or otherwise would have lost their license decades ago.
Some of us do staff free clinics, but even then there needs to be a formality to maintain appropriate interactions that protect us and our patients. The closest I have ever come to anything like this was when I was a flight surgeon in the Navy. Half my week was spent in the squadron space working alongside my pilots, giving advice to my commanding office for medical readiness for deployments, and giving informal medical advice or arranging people to be seen in clinic. I could only do this because the military is a socialized system, billing didn’t exist, and there were stronger protections for physicians.
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u/Peter_G Aug 13 '21
You know, I wonder sometimes about North American society. Canada and America both do this thing where they hand off responsibility to the state, or some arbitrary authority. When I see this, I have to stop and ask myself, why would no one here do that?
A doctor, with this sign in their car, stopping and doing consultations with needy people on the side of the road would likely be arrested and charged for not meeting some arbitrary requirement that's set by some board somewhere who makes rules for hospitals and doesn't bother to think how it limits the ability to act on real problems. No doctor would consider doing this. It's outside the system, they wouldn't endanger themselves that way, even to do good.
It's strange, because we get to see these exemplars of humanity, but it's always people who have to work under the most extreme of conditions, without proper equipment, without a support team or everything we'd demand for every patient here in North America. None of us, not a damn one of us ever meets our potential as human beings, because nothing demands it of us. We never have to struggle, thus never understand what we are truly capable of.
It's a sobering thought.