Hello,

I actually agree with you about all of the other sources of blame.  I 
know insurance companies are very powerful as well.  It is hard for 
doctors to fight this.

I do think though, that b/c doctors have stopped listening, that that 
has particularly bad effects on anyone who cannot speak quickly, 
clearly, or comprehensibly.  and that includes a lot of people with 
disabilities but it also includes most of us with mental illness, 
severe.

I am much better/in remission but the problem for me was lack of 
insight.  that plus speech problems related to CP meant I would go into 
doctors' offices and sit in frozen silence or talk in a way that was 
very difficult to understand.

through a combination of talk therapy, medication, a couple of 
hospitalizations, and a lot of work on my own on communicating, I have 
insight and much improved speech capacity.


one thing that might help is training people how to talk to doctors.  
this is something I am working on.

library science has a concept called 'health literacy' and it involves 
the concept that when doctors provide information, patients need to be 
able to understand it.

but then there is also talking to the doctor, and that is a skill.  
what do I say and how many issues do I bring up and etc?  I have 
learned to write things out in advance and try to list a couple of 
issues and prioritize.

I can't do anything about all of the abuses and etc. that go on but I 
think teaching doctors and patients to talk more effectively, 
developing principles and sharing them *in a way that does not blame 
either patients or doctors* would really help.

as for the rest of it, I hope for reform.  the doctors I am working 
with say that there are a lot of people working on this in different 
ways.

take care,

Mary Katherine


-----Original Message-----
From: [log in to unmask] <[log in to unmask]>
To: [log in to unmask]
Sent: Tue, 2 Sep 2008 12:57 pm
Subject: Re: managed care (was Re: Pajamas Media >   Sarah Palin's Baby 
and the Rights of the Disabled ?)


You can blame several sources for this:

1) An insurance paradigm that emphasizes costs over benefits
2) A government that shifts funds away from health care towards other 
needs
such as war
3) A government that isn't willing to increase taxes so we can take 
care of
our own
4) Doctors who have less time to listen to their patients and are
encouraged by lower reimbursement rates to maximise their patient loads 
at
the cost of attentiveness to their patients
and 5) Businesses who can't afford to provide adequate coverage in their
medical plans to their employees and families

The shift to not listening is everywhere, not just with the disabled.

Kat

Original Message:

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