Health is a unique profession. It is seen not only as a commodity, but perhaps as the right of every person in society. Compared to other professions in the service sector, there are unique differences in the training and practice of doctors.
Consumers know that the quality of most consumer goods or services follows a bell-shaped curve in which some products are rubbish, some are exceptional and some are the poorest. If consumers understand this call curve in consumer products, they don’t realize that the call curve exists in the medical knowledge of doctors. From a patient’s point of view, the dissemination of medical knowledge is similar to the shark fin, where most doctors are good, but few doctors are experts. Part of this misconception is due to the fact that most doctor’s reception rooms are always full. But is it true?
As Director of the Board of Directors of the National Resident Recruitment Program (NRMP), I have had the privilege of researching alumni assessments consistent with resident authority. Contrary to popular belief, we see a bell curve in almost every aspect of our newly created applications for doctors (insert, blue curve). Similarly, we see a bell-shaped curve in the results of our exams during residency or internship (rectangle, blue curve).
Doctors are aware of this distribution of assessments, and although they acknowledge the existence of the bell curve, they keep this information secret and never appear in public discussions. Few patients who know this secret do not want to recognize it for many reasons. If a person is forced to see a particular doctor who has no experience, he does not want to admit that his doctor is incompetent. Because the medical profession is considered a noble profession and doctors are more sacred than you, patients continue to ignore the bell curve. But should we? What is more important than your own health?
I read With great interest Dr. Gawand’s article, published in the New Yorker in 2004, and is relevant until now. Even in our time, we don’t have statistics on how to identify a doctor with experience in his field. Online resources such as healthgrades.com, vitals.com, etc., provide patient doctor reviews and basic information without mentioning the experience indicators that can most affect your health. Despite the great need, such statistics do not currently exist in today’s online ecosystem. Patient reviews reflect how good the doctor’s communication skills are – no more and no less. An article about the scientific study found that patients who were most satisfied with their care were 26% more likely to die than those who were dissatisfied with their care. This topic deserves careful analysis, and I plan to analyze it another time.
As I mentioned above, there are several doctors who still need a long waiting list of patients. But are they really specialists in their field? Maybe, maybe not. To understand why these doctors have very busy clinics, we need to understand how patients are sent there. Patients usually turn to specialists on the basis of a sundress radio from friends or relatives or on the recommendation of their doctor. Who do you think your friend will send you to? Obviously, the specialist he is most pleased with. Oh! If you believe in the study I mentioned above, your friend sends you to a doctor who has a 26% higher chance of dying than a doctor whose patients are dissatisfied. Aren’t you confused? What about the second scenario, when the therapist sends you to a well-known specialist? Here’s the fork. If your therapist, through his colleagues, knows who the real experts are, you are in safe hands. But more often than not, it sends you to a specialist with whom you would like to interact. Specialists scold the guide doctors, and the doctor, who can better sell himself, gets more referrals.