Thursday, June 9, 2016

“ I’m Glad I Live in the United States”
An American conservative after having a renal stent placed to relieve his hypertension and deteriorating renal function
I just spoke to a 68 year old conservative friend who underwent a renal stent procedure to remove an atherosclerotic plaque blocking  a renal artery.   He was home after a one day stay in the hospital.   During his brief hospital stay,  he underwent a series of tests, including an MRI to identify the plaque,  and a vascular insertion in the groin, with threading up of a stent, under radiological guidance, to remove the plaque. He is now home, feeling tired but grateful .
He believes that performance would not have been performed so quickly in more socialistic countries where he would hve  been forced to wait in line.
This may or not be true.   
But as I noted in a previous blog “Comparative Health Statistics among Nations, “  Americans diagnosed with cancer survive longer, receive treatment for diabetes sooner,  get hip and knee replacements quicker, are referred to a specialist more expeditiously, and  are more likely to receive diagnostic imaging tests.
But promptness in diagnosis and treatment costs more.  And it is not reflected favorably  in overall health  statistics in the U.S. compared to other nations.
As  a physician,  I  believe in randomized clinical trials and controlled studies to determine  the best outcomes of any given diagnostic or treatment procedure (L.D. Fiore and P.W, Lavori,   “Clinical Trials Series: Integrating Randomized Comparative Research with Patient Care,” NEJM,  June 2, 2016).
But as an observer of the social scene,  I am also acutely aware of the power of anecdote, anecdotal  stories told by patients to one another,  and the inborn instincts  of physicians to use the latest technologies to treat patients as best they can. 
Perhaps I have fallen victim  to anecdotage.  As Benjamin Disraeli (1804-1881) once remarked, “ When he fell into his anecdotage, it was a sign for him to retire.”   Which brings to mind,  two other notable and quotable British subjects,  Winston Churchill, (1874-1965), “The inherent vice of capitalism is the unequal sharing of blessings; the inherent virtue of socialism is the equal sharing of miseries,’  and Margaret Thatcher  (1925- 2008), “ The problem with socialism is that eventually   you run out of other people’s money.”
It is sometimes said, “ When they say it’s the principle  and not the money, it’s the money.”  To this would add, “When they say it’s the moral principle  of  treating the general population,  or spending  money on me,  money is no object.”  “Do what you have to do, doctor.”

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