Los pacientes no son consumidores

Más Krugman. Excelente entrada en su blog del NY Times titulada Patients Are Not Consumers. Transcribo la entrada:

I keep encountering discussions of health economics in which patients are referred to as “consumers”, after which the usual mantra of freedom of choice is invoked on behalf of voucherizing Medicare, or whatever.

We used to know better than this.

Medical care is an area in which crucial decisions — life and death decisions — must be made; yet making those decisions intelligently requires a vast amount of specialized knowledge; and often those decisions must also be made under conditions in which the patient is incapacitated, under severe stress, or needs action immediately, with no time for discussion, let alone comparison shopping.

That’s why we have medical ethics. That’s why doctors have traditionally both been viewed as something special and been expected to behave according to higher standards than the average professional. There’s a reason we have TV series about heroic doctors, while we don’t have TV series about heroic middle managers or heroic economists.

The idea that all this can be reduced to money — that doctors are just people selling services to consumers of health care — is, well, sickening. And the prevalence of this kind of language is a sign that something has gone very wrong not just with this discussion, but with our society’s values.

• Participar en la toma de decisiones en las que el paciente está en una situación compleja.
• A partir de la información general ayudar a tomar decisiones para pacientes concretos.
• Exigencia de altos estándares profesionales.

Son muy interesantes los comentarios de los lectores. Por ejemplo. El comentario 214 (Ken, de Seatlle) sostiene que la mayor parte de los contactos con los médicos son revisiones rutinarias (que podrían tratarse como un producto del mercado). Es como un coche: aseguramos el riesgo de accidentes pero no el mantenimiento. Quizás con este comentario se abre la puerta a la estandarización de una parte de la atención sanitaria (y, por lo tanto, no es imprescindible que la realicen médicos) y a preservar el núcleo la práctica asistencial (la colaboración del médico en la toma de decisiones individuales)