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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Monday, February 17, 2003

    Why Patients Aren’t Consumers: And doctors aren’t merchants. This is a rant I’ve been meaning to put down for a long time, especially after listening to a plastic surgeon on ABC analyze Michael Jackson’s face. She used phrases such as “end-stage nose” and “nasal cripple,” in ways that indicated they’re in standard use among plastic surgeons. But when the reporter asked why a surgeon would do that much surgery on someone, she refrained from criticism. Instead, she made excuses, saying the plastic surgeon’s job is to give the patient, his customer, what he wants. If he wants an ever-narrower nose, then it’s the doctor’s duty to give it to him. Even, apparently, if it’s likely to be to his detriment.

    Then, comes this story about the use of an unapproved wrinkle treatment by plastic surgeons. It’s illegal to use it in the US, but plastic surgeons use it anyway, because their patients demand it. (And because, at $750 to $1,500 per treatment, it’s lucrative.)

    This sort of consumerist attitude isn’t unique to plastic surgery, unfortunately. Too often, we give in to the temptation to “give the patient what they want.” From the prescription for unneeded antibiotics, to the overuse of sedatives and narcotic analgesics, to treating ailments over the phone without ever examining the patient, most of us have been guilty of it at some time or other.

    But our motto shouldn’t be “the customer is always right,” because the customer often isn’t right. What the patient thinks is indigestion may really be a heart attack; the stomach flu an appendicitis; or the chest cold a pneumonia. It’s our duty to make sure those symptoms are properly diagnosed once they’re brought to our attention. To do otherwise is to betray our patients' trust.

    As one woman who uses the illegal wrinkle injection put it:

    "I trust my doctor. And after all the work and money we have put into my face, she is not going to put anything in it that is going to make it fall apart."

    Might Michael Jackson have said the same thing?

    posted by Sydney on 2/17/2003 06:56:00 AM 0 comments


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