all
So do I.
... if we stopped putting up with substandard healthcare, there would be less and less substandard healthcare.
Stephen Nagler
I absolutely agree with that. To know that you're receiving substandard healthcare, however, you have to educate yourself, and ask a lot of questions (of yourself, of doctors, of friends, neighbors ... and that includes internet neighbors).
Unfortunately, there is a bias in the world towards doctor's and many healthcare providers getting paid regardless of the quality of care provided. Part of that is because patients are not educated enough to know that they are getting bad care, and part of it is the myth that all doctors are smart and capable because of the rigors they went through to get their degrees. The fact is, like all professions, half of all doctors finished in the bottom half of their class.
Most people don't make the effort to make sure the doctor they are unhappy with knows they are unhappy because most of the money comes from insurance so it is no sweat off the patient's back financially speaking. Another reason is because one does not want to tick off the guy who might have the answer to their problem if you could get that guy to get off his tail. (It's kind of like not ticking off your co-workers because you never know which one will be your next boss). Beyond expressing dissatisfaction, one has little recourse except to bring a lawsuit, and doing that jeopardizes your future ability to get good care. If you get a rep for lawsuits, prospective doctors won't take you as a patient. Going to another doctor causes little hardship for the doctor you leave. 90% of the time they won't even notice you stopped using them unless you tell them so, and even if they do, they don't really care. Demand way outstrips supply, so doctors don't see a change in income.
There also seems to be a hesitancy among healthcare providers to "out" the bad guys. I don't know why that is.
Additonally, there are many laws that protect doctor's business. Only doctor's can provide certain services (in some cases this makes sense; in others it does not). Only the ordering doctor can give a patient test results. This gives them ample opportunity to cover their tracks if they screw up. When the doctor controls all the information it makes it very difficult for a patient to oversee their doctor - and that is precisely what patients should do - oversee the guy working for them. Unfortunately, few doctors see themselves as working for the patient. Hospitals are not required to post performance data (at least in my state). There are other such barriers that protect doctors interests at the expense of patients. I understand how these laws came to be and the key assumption in creating them is "the doctor knows best". That simply is not always the case. Believing that and passing such laws diminishes the ability of the person who wants to take charge of his own healthcare. It makes them reliant on the "system" rather than fostering control of it.
All of these things give healthcare providers too much power - financial power, psychological power, legal power.... And on top of all that, insurance rules also get in the way. Lastly, when you are sick, you're often not able to shop around for the right doctor - you have to go with what you got. From that perspective, it is my opinion that doctors should be held to a higher level of integrity and be saddled with a degree of fiduciary responsibility that goes beyond what is expected in most other professions.
For these and other reasons, as a rule, healthcare consumers have been loath to take back control of the "system". I think the biggest single reason for the reluctance is because most healthcare consumers are intimidated by their doctors, and the whole system. That's why I encourage people to use the power of the internet to educate themselves. Being your own advocate is the best way to protect yourself. Patient education is the biggest thing that will help consumers regain control of the system, and that control is what will raise the standard of care. Asking questions on web sites is one form of educating yourself; one way to not feel so intimidated; one way to get ideas and gain the confidence to fend for yourself while sitting in the intimidating environs of an examination room - you in your underwear seeking help because you are sick vs. the doctor and institutions that have more (undue) power than you from a lot of perspectives.
Sorry for the long post, but if you haven't picked up on it yet, this is something I am passionate about.
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