Joshua Tree

Particpatory medicine

One of the challenges with finding alternative approaches to healthcare that you know are trustworthy is that new or unconventional forms of treatment often don't have the benefit of financial resources for going through published peer review processes that mainstream medical practitioners rely on. Here is a new initiative that might help. The nonprofit Public Knowledge Project in Canada has launched Open Journal Systems as a journal management and publishing system to expand and improve access to research.

OJS assists with every stage of the refereed publishing process, from submissions through to online publication and indexing. Through its management systems, its finely grained indexing of research, and the context it provides for research, OJS seeks to improve both the scholarly and public quality of referred research.

The Journal of Participatory Medicine will be published free online using this system to give patients a trustworthy tool for understanding their needs and conditions and encouraging them to participate in their own wellness. For anyone going through what we have been through with Joshua, you might want to find out more about the journal from this article by Kevin Kelly.

[via WorldChanging]

This is going to sound...

Paranoid. I don't want to be completely over-the-top-critical-of-the-medical-profession. So let me first acknowledge that doctors and nurses and medical researchers have done a tremendous job of getting us to a place where frankly incredible things can be done to overcome disease. But, as this New Yorker article by Atul Gawande points out, there is an odd dynamic at play in the relationship between doctors and patients that I have never seen in writing before.

I grew up thinking that doctors choose their profession because they have an innate desire to help people. No doubt many do, but I don't think one can call it altruism. Altruism is, economically speaking, irrational. Like buying solar panels for your roof because you believe it's good for the environment, even though it costs you more than buying electricity from the grid. Very few doctors are willing to practise if it doesn't earn them a decent living, and I don't begrudge them that. But if that is so, they have a conflict of interest between their financial desires and the health of their patients. There are many cases where preventive measures - which often cost the patient virtually nothing - would obviate the need for expensive surgery and medications. As I mentioned in this comment a few days ago, healthy diet and lifestyle choices can go a long way. So the question is, why don't doctors just tell us that? Gawande wrote:

Seeing a patient who has had uncomplicated, first-time gallstone pain requires some judgment. A surgeon has to provide reassurance (people are often scared and want to go straight to surgery), some education about gallstone disease and diet, perhaps a prescription for pain; in a few weeks, the surgeon might follow up. But increasingly, I was told, McAllen surgeons simply operate. The patient wasn’t going to moderate her diet, they tell themselves. The pain was just going to come back. And by operating they happen to make an extra seven hundred dollars.

If you want a theory on why doctors are increasingly relying on more expensive treatments than they did in the past, and why there seems to be an inverse relationship between the costs of health care and the health of a population, read the article. With South Africa now investigating a national health insurance system, it's worth considering.