An article today in Kaiser Health News discussed the measure of Americans' confidence in reform of our current health care system - confidence is down just in case you were wondering. Much of what was cited in the article was fear of change. That fear was found to be based on mistaken beliefs about the current proposals - a government take-over of health care, covering all 'illegal immigrants' etc.
On a daily basis, whether practicing medicine in the clinic or the hospital, we as physicians counsel patients on their diagnoses and best choices of therapies. Recently, I talked to a mother about getting a spinal tap done to rule out meningitis in her young son with fever. She had significant fears about what this meant and what the risks were. I listened, tried to address those fears and any questions she had while advocating that this was the best therapeutic choice. We are all trained in this, either formally or informally, and it is essential to practicing good medicine.
In discussing the health care reform process, some of us seem to be forgetting some of the basic tools that we use to encourage patients to follow what we see as the best choice of therapy. Listening, addressing questions and concerns in plain language and taking into account where the person is coming from while advocating for what we see as the best option are things we should consider applying to our engagement in the current debate.
There are significant fears in people’s minds about health care reform as the article pointed out. I think a lot of that fear can be assuaged through using language that is neutral yet accurate – others have proposed talking about ‘a family doctor for every family’ or a ‘pediatrician for every child’ instead of ‘universal health care.’ Specifically asking what is it about government-run health care that people are afraid of and then addressing whatever fear that is – bureaucrats will not be taking the place of your doctor.
As physicians, we counsel patients on a daily basis to take medications and undergo procedures that have inherent risks, that they have fears about but that we think are the best option. We have the training to do so. While this is nothing new, this study I think serves as a good reminder that we should use the training that we have to advocate for the health care reform that we see as best for our patients and try not to fall back on political rhetoric (even if instigated by the ‘opposing side’), confusing terminology or brush off people’s concerns and fears. I believe that the current proposal with a public health insurance option is the best for my patients, but the patients have to want it too.
Alex Foster, MD, MPH