Active Thinking Topic 73  - Healthcare Vs Sickcare - Are Paients & Doctors Clueless?

9 January 2024

Any replies to the organizer - thormay@yahoo.com

Venue: Zoom online

 

Recommended Viewing: Dr Chatterjee Clips (December 11, 2023) "The 8 Things Causing Illness Most Doctors Can't Treat | Dr. Robert Lustig" @ https://www.youtube.com/watch?  (18 minutes)


Talking Points

1. How has the relationship between medical doctors and patients been affected by "Dr Google" (Internet access to medical information)?

2. There is now an immense amount of medical information available online, not merely about sickness but also about maintaining good physical and mental health. What part of the population benefits from this, and who isn't touched by it? How can this knowledge be spread more widely?

3. What changes would you like to see to the training of doctors? Note that medical education is long, content heavy, but conservative. Medicine attracts people who are disciplined, have good memories, but do not necessarily have much talent for scientific inquiry. Few medical doctors are scientists.

4. Medical science is still in its infancy. What are the implications of this? [I have seen estimates of the number of cells in a human body ranging from 34 trillion to over 60 trilion. Each cell is a complex biological factory. Then there are over 100 trillion other critters hanging out in the corridors - bacteria, viruses ..etc. Many of these are essential for human survival. With such vast and complex systems, basic scientific method can hardly be used. Rather researchers have to hypothesize models for parts of the body, and make statistical estimates ... AI is helping now. ]

5. What is the best way to take informed responsibility for your own physical welfare? Fewer and fewer patients have any long term relationship with a GP and GPs themselves now only deal with a limited range of issues. Your contact with a GP, probably a stranger, may be just a few ten minute visits a year.

6. Where has body management gone wrong? Whose fault? What is the fix? Old videos from 50 years ago show few Australians to be overweight. On current trends, more than 18 million Australians will be overweight or obese by 2030 (https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/australias-first-national-obesity-strategy-launched-on-world-obesity-day ). Obesity is connected to 30 different cancers, and over 200 diseases.

7. Why do hospitals work so badly? What can be fixed? Hospitals are large organizations set up for sick care (not health care). Worldwide, hospital personnel cause huge numbers of medical errors, many fatal.

8. What are common expectations that patients have about doctors, and that doctors have about patients? When do such expectations, which may be wrong, become a problem?

9. The Welfare State, as per Australia, assumes some official responsibility to assist with the general health of citizens. How extensive should this assistance be? There is now a large and increasing number of professions related to maintaining good health, ranging from lifestyle gurus to physiotherapists to psychologists .. etc.

10. How much thought and time do you yourself put into body maintenance each day, each month ... How has this changed over time?

Extra Reading & Viewing

Sam Ottley (Dec 3, 2019) "Systems Thinking in Health Care - Health Care vs. Sick Care." Medium @ https://medium.com/@slottley/systems-thinking-in-health-care-health-care-vs-sick-care-30ee3b2268a

A.M.A. (2023) "Health is the best investment: shifting from a sickcare system to a healthcare system". Australian Medical Association @ https://www.ama.com.au/health-is-the-best-investment  [Quote: "The view that health is a cost to be managed, as opposed to an investment to be made, has resulted in a healthcare system that responds to poor health outcomes rather than actively preventing them .."]

Australian Government (2021) "Physical activity and exercise guidelines for all Australians". @ https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians 

Stuart Layt (September 21, 2020) "Up to one in seven medical diagnoses could be wrong, study reveals". Brisbane Times @ https://www.brisbanetimes.com.au/national/queensland/up-to-one-in-seven-medical-diagnoses-could-be-wrong-study-reveals-20200920-p55xf9.html  [Quote: "In a perspective article published in the Medical Journal of Australia, two leading clinicians, Professor Ian Scott, from Brisbane’s Princess Alexandra Hospital, and Associate Professor Carmel Crock, from the Royal Victorian Eye and Ear Hospital, analysed diagnostic error rates in the United States.
They used the data to extrapolate to Australia the number of diagnostic errors, finding an estimated 140,000 such cases annually, with 21,000 cases of serious harm and between 2000 and 4000 deaths. ... Professor Scott said they were comfortable extrapolating from the US data because the two systems were very similar from a diagnostic standpoint. ..."Patients [also] have a certain responsibility to be concise and accurate in their medical history, not to withhold any information, because that will obviously put doctors on the wrong track."]

Amanda Gearing (Sun 23 Oct 2022) "Patients dying daily due to poor ‘soft skills’ among Australian surgeons, experts warn". The Guardian @ https://www.theguardian.com/australia-news/2022/oct/23/patients-dying-daily-due-to-poor-soft-skills-among-australian-surgeons-experts-warn  [Quote: "More than 1,000 Australians die unnecessarily in hospital each year due to avoidable failures by surgeons, according to experts calling for a senate inquiry.
Graham Beaumont, PhD, and Dr John North are both long-term members of audit committees that review surgical mortality in Australia. They say patients are dying every day as a result of poor decisions to operate, communication issues, and lacklustre teamwork in operating theatres, as well as incentives for doctors to pursue “futile and unnecessary surgeries”]

Dr Chatterjee Clips (December 11, 2023) "The 8 Things Causing Illness Most Doctors Can't Treat | Dr. Robert Lustig" @ https://www.youtube.com/watch?v=r5N8gamJ84I

Dr Chatterjee Clips (Sep 12, 2023) "You May Never Eat Sugar Again After Watching This! | Dr. Robert Lustig" @ https://www.youtube.com/watch?v=YKwpF-JjQkY 

Kwak Yeon-soo (12 Dec, 2023 "Millennials ageing faster than their parents, studies and experts say - People now in their 30s and 40s are more health-conscious than previous generations yet their health is declining faster than older people’s, studies show" South China Morning Post @ https://www.scmp.com/lifestyle/health-wellness/article/3244642/millennials-ageing-faster-their-parents-studies-and-experts-say-heres-why-and-how-they-can-slow?module=hp_section_lifestyle&pgtype=homepage 

Ian Verrender (19 December 2023) "How Ozempic could affect the health of the global economy in more ways than one." ABC @ https://www.abc.net.au/news/2023-12-19/ozempic-obesity-diabetes-health-challenges-impact-global-economy/103244056  [Quote: "Ozempic could radically restructure our health and food industries, boost the global economy and possibly even reshape our future. ... While a breakthrough in the treatment for type 2 diabetes, for reasons that remain a mystery, the drug also allows patients to lose remarkable amounts of weight, even for those who have been unable to shift body mass since birth. Hence, the insatiable demand. It has become such a phenomenon that it has elevated manufacturer Novo Nordisk to the throne of European business. Now the European Union's biggest corporation worth more than half a trillion US dollars ..."]

Ashlee Vance (December 19, 2023) "The Most Secretive Longevity Lab Finally Opens Its Doors - Retro Biosciences, a startup with $180 million from Sam Altman, has a simple and audacious goal: Add 10 good years to your life. And until now, we haven’t had a glimpse of its best ideas". Bloomberg @ https://www.bloomberg.com/news/features/2023-12-19/longevity-startup-retro-biosciences-is-sam-altman-s-shot-at-life-extension 

Ellen Huet (December 19, 2023) "Tech titans, venture capitalists, crypto enthusiasts and AI researchers have turned longevity research into something between the hottest science and a tragic comedy". Bloomberg @ https://www.bloomberg.com/news/features/2023-12-19/jeff-bezos-larry-page-tech-ceos-spend-millions-to-find-how-to-live-longer 

Atul Gawande (23 January 2017) "The Heroism of Incremental Care - We devote vast resources to surgeons and the like, while starving the physicians whose steady, intimate care helps many more". New Yorker @ https://www.newyorker.com/magazine/2017/01/23/the-heroism-of-incremental-care?utm_source=pocket&utm_medium=email&utm_campaign=pockethits  [42–54 minutes reading time] [Comment: This is a very long, thought provoking article on maintenance (primary care) Vs intervention, mostly in medicine but with clear application across the spectrum of activities & institutions. Intervention always gets the funds and marks the heroes of the revolution. It's the political poster child. However it is long term primary care that is far more effective in every field. The same dilemma happens with individuals - long term self-maintenance is a hard sell ]

Peter Attia MD (477,293 views Jun 2, 2023) "How and why to perform a step up exercise". @ https://www.youtube.com/watch?v=v2GfVnjmY7c  [Quote: "Get the 5 Tactics in My Longevity Toolkit and my weekly newsletter here (free): https://bit.ly/42sUBWq  ... In this clip, Peter and Beth Lewis demonstrate how to properly perform a step-up. Additionally, they explain the mobility and strength benefits of the exercise".

-----------------

Healthcare Vs Sickcare - Are Paients & Doctors Clueless? (c) Thor May 2024

return to Ddiscussion