We can understand the systemic flaws in the U.S. "healthcare"/sickcare system by examining how doctors choose to die, which is quite different from the experience of their patients.
"Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.
It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently."
"That is the best article I have read in a long time, and I AGREE WITH EVERY SINGLE WORD. I have a living will and an advanced health care directive. There's a bright red card in my wallet with this on it (if you come in the ER unconscious or confused your wallet gets checked). I've told my wife that if I'm badly injured in a car crash but can be fixed up, to have me admitted to the ICU and tortured (the ICU is really a torture chamber). If I have terminal cancer, I would refuse chemotherapy for all but a few types that respond well to it (most don't). I want to stay a home, with a hospice nurse if necessary, and die in my bed.
By the way, the Feds passed a law saying doctors HAVE to do everything if the patient is mentally incapable of deciding for themselves, unless the patient has a living will, advanced health care directive - or a family member or other adult appointed as legal guardian (which will NOT be the case in the example the author gave - sudden unconsciousness due to massive stroke). This was done during my career. I used to be able to have a sit-down with the family and decide whether or not to "do everything" when, say, someone with documented terminal cancer came in with some near-death condition and was "out of it".
Now, that's illegal, and I could get into enormous trouble - it's insane! Here is exactly what could have been done to me: a $50,000 fine and loss of the ability to bill Medicare for five years. As an emergency physician that would have put me out of business, as Medicare is one of the main sources of income for emergency physicians."
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