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medpundit |
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Tuesday, November 26, 2002I disagree with you. I think these poll results have everything to do with the Tuskeegee Incident - which was all about medical professionals conscientiously setting forth to conduct experiments on blacks without their knowledge and consent - and nothing to do with "To Err is Human," which largely had to do with inadvertent and/or systems mistakes that occur during efforts to provide treatment to patients. Could you expound a bit on why you dismiss Tuskeegee as a central facet of black distrust of medicine, but are so quick to shoulder the Institute of Medicine with the blame? If you were to poll blacks across the nation, do you honestly think that more of them would have familiarity with "To Err is Human" & a report on racism in medicine or the Tuskeegee Incident? See, for example, this op/ed from last month on the black artificial heart recipient. His beliefs may have been flawed or unfounded, but they were not shaped by studies on wrong-side surgery and medication errors. I fear that, given your interest in discrediting the publications by the Institute of Medicine, this may be a case of having a particular hammer, and seeing these survey results as a particular kind of nail. I admit that black America isn’t my social milieu, so I can’t say with any certainty how strongly the Tuskeegee incident colors the community’s views on physicians. The bit about the father of American gynecology and experiments on women slaves mentioned in the editorial he links to is unfortunately true. But, the "To Err is Human" reports and the report on racism have both been in the news a lot more lately than the Tuskeegee incidents, and people tend to remember most what they've recently heard a lot about. I also doubt that the Tuskeegee experiments have much to do with the white sentiments, which were also strongly mistrustful of doctors. (And for the record, I’m not out to “discredit” the publications of the Institute of Medicine. Only those that are based on poor statistics and faulty reasoning. In fact, I spoke favorably of their report on the health care system last week.) Nick Schulz sent along some ideas on the trust issue, though, that are extremely pertinent and right on the money: Our healthcare system is so totally confusing and transparency is so difficult that it makes it almost impossible for people to feel that the system is trustworthy - and that suspicion extends (unfairly or not) to doctors. Is my doctor prescribing this because I need it? How much does he get out of this? Is this procedure really necessary? Does my insurance company think it's necessary? Does the federal government? Will this procedure be approved by my insurance provider? How do I weigh all these things against what I believe I need to be healthy and well? A huge trust builder is transparency (same goes for, say, financial markets). As the layers of bureaucracy pile up, it makes transparency difficult. This - more than anything else like, say, cost - was what doomed Hillarycare. I can't overstate how much people crave simplicity - I bet they'd even be willing to pay more for it. In truth, this probably has more to do with the issue of trust than either the Tuskeegee experiments or the IOM reports on errors and racism. posted by Sydney on 11/26/2002 11:05:00 PM 0 comments 0 Comments: |
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