Reply #33: These comments of Dean to NH doctors are very appropriate today.

[madfloridian]

That was a special speech, and we watched it on C-Span in 2003, December. His comments are so down to earth about the changes in medical care. It is almost sad how it has changed and is still changing.

SNIP..."So if somebody who was in the older generation who was quite far along got really sick, and things weren’t going well, I could go to the family and say, “Look, things aren’t going well. I can put tubes in there, machines on there, and turn all this stuff on, but I don’t think we’re going to have a great outcome with this one, tell me what you want me to do.” What they would do is they’d go back to their family, they’d bring people in from all over the country, because that’s where families are these days, and they would have a big family conference. If the patient was able to participate in his or her care, they’d be included.

And they’d come to me in a couple of days and say one of two things. Sometimes they’d say, “Well, you know, my dad was a real fighter right to the end, and we want you to do the works.” And we would do the works. And sometimes it worked, and a lot of times it didn’t. Or, they’d more often say, “You know, my dad never wanted to be kept alive with machines, and at his age, I think we ought to just let nature take its course.” And we would.

You can’t do that today. You can do it in rural New Hampshire, but you can’t do it in too many places because what happens is, when someone gets sick, they get wheeled into the emergency room; they see a doctor they never saw before; maybe their on-call physician’s there or not. Then they get sent upstairs to another set of specialists they’ve never seen before. The set of specialists they’ve never seen before is not going to come and say “I think we’ve done everything we can,” because they don’t know the patients, they don’t know the context, and they’re worried about the lawyer looking around the other side of the curtain. It is really a problem..."END SNIP

I had these problems with my father in the mid 80s, my mother in the mid 90s. There was a huge difference in approach just in those 10 years. Luckily our doctor was still the same practical, kind one.
She has retired now, and we are seeing the huge change in going to a new doctor in a large group here. Tests, more tests, appts, more appts. Very frustrating.