PATIENTS WANT, NEED and SHOULD HAVE MORE CONTROL AND MORE CHOICE

The rapid advance of medical science over the past century means patients now have more therapies available to them than ever before. Historically, patients relied on physicians to provide them with information about medical developments. With the arrival of managed care in the 1970s, physicians have seen their caseloads rise. According to an article in the May 2004 Journal of the American Medical Association, physicians spend less than one minute discussing treatment during a 20-minute office visit, on average. About half the time, doctors fail to ask patients whether they have any questions about what has been discussed during the visit. As doctors become more hurried, they have less time for patient education. Patients are finding it increasingly necessary to take matters into their own hands.

The Internet gives patients a powerful new tool with which to educate themselves and manage their health care needs. Many Web sites provide clinical information and resources directly to patients. These include sites dedicated to providing information on treatment alternatives, clinical trials, and prescription drugs, as well as resources for patients afflicted with specific diseases. A few hours on the Internet can substitute for a face-to-face education that would be costly for a patient. Recent reports, including a January 26, 2004, article in American Medical News, suggest it may actually save the doctor valuable time when patients inform themselves before an office visit.

Another trend that may explain consumers' interest in health information is the rise of consumer-driven health care plans. The heath insurance company Aetna, for example, found enrollees in its health reimbursement arrangement (called HealthFund) were more likely to use the Internet to manage their own care. A February 2004 study found HealthFund enrollees used HealthWise (an Internet health information Web service) twice as often as the control group, and the health information Web site InteliHealth 48 percent more often. HealthFund enrollees also searched formularies for drug price information almost twice as often as the control group.....

Home pregnancy tests are so common they are sold in pharmacies, grocery stores, and even inexpensive dollar stores. Ovulation predictor tests and tests for menopause, cholesterol, and other conditions also are widely available. For about $50, parents can buy an EarCheck Middle Ear Monitor that uses sonar to check for fluid behind the eardrum, which may indicate an ear infection. One of the most common reasons kids see a doctor, ear infections account for 20 million office visits annually in the United States. Likewise, kids often develop sore throats that don't require a physician visit. Families can buy a QuickVue Strep Test for about $90, providing 25 tests. The simple test differentiates strep infections, which require a physician visit, from viral infections, which do not.

Why do patients value having more knowledge about what ails them without having to run to the doctor's office? Probably so they can make better decisions about which symptoms require consultations and which they can treat themselves.....

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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