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Consumerism in healthcare and the Physician-Patient Relationship

On PsychCentral.com, Dr. Rick Nauert writes in this post entitled Money Changes Physician-Patient Relationship – 

“We have forgotten that aspect of professional folk wisdom,” Hall said. “Doctors need to make their treatment recommendations in the context of what patients can and can’t afford, with the understanding that some patients can’t afford what they might recommend.”

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The Challenge of Care Coordination

As an endocrinologist, care coordination is something I struggle with in my clinic. There being only 200 or so endocrinologists in the Philippines, I often see patients from places where there are no endocrinologists. They travel great distances to see me. As you can imagine, persons with diabetes will need care from others such as an ophthalmologist, cardiologist, nutritionist, dentist etc. These healthcare professionals may or may not be available where the patients live. If they are not available where they are, I have to choose who to refer to in the faculty medical arts building (attached to a medical school and a university hospital) where I hold clinic and ask my secretary to schedule an appointment for them. While all medical specialties are housed under one roof, scheduling can be hit or miss. Sometimes, the patient can be seen that same day before they travel back home and sometimes not. Tracking whether the patient has indeed been seen is another problem. I can find out months later when the patient comes to her appointment with me that she was not seen for example by an ophthalmologist despite my referral.

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