Another VA lesson — Healthcare needs to stop being like flying business class

The VA healthcare story has me thinking about the good aspects of delays in medical therapy. Typical American intuitive thinking holds that healthcare waiting lists are a bad thing. The two central tenets of this mindset are that healthcare brings health, and most of medicine is as time sensitive as cardiac arrest or heart attack. Yet, when we engage our slow thinking minds it’s easy to see the flaws in such an early-intervention shortcut (heuristic). The business about healthcare not bringing health has been addressed here many times over. The short story is that in general we do best when treating the very sick, not so good with the worried well, and terribly with those near end of life. What I want to use this essay to focus on is the early-intervention mis-thinking and truth-denial aspects of the VA story. The reason is that there is an important lesson about the way we (should) think about healthcare—a mindset or framework. (Before beginning, let’s set out a given: there is no defense of quality care variations described in the WSJ today, in which some VA hospitals have 10-fold higher rates of hospital infections than other VAs. That needs to be fixed in the same way private hospitals fixed it a decade ago.) Let’s begin the wait-list/truth-denial story with the fact that studies show that outcomes in the VA healthcare system compare favorably to those in the private sector. Many people do not believe such data because, to them, it seems implausible. They have pre...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs