This is from a blog on medical disease management:
It is difficult to overestimate the mostly good and sometimes bad influence of medical training on attitude, values and career choices. One of the most pervasive outcomes of med school and residency however, is the enculturation of young trainees toward an acute care focus. We become addicted to the thrill of spotting a diagnosis and tailoring a successful treatment. That’s not necessarily bad: physicians are needed first and foremost to care for sick patients. After many rewarding years of helping patients in extremis, prevention – the art and science of non-events – is, well, so boring.
This contrast between chronic care ennui and acute care excitement has gone unexamined as one cause of the widespread lapses in health care quality. But the DMCB thinks it is out there.
The DMCB appreciates there are other forces at play. Physicians lack time, trust in the system, training, incentives and support. On the other hand, when physicians really want to effect change, it appears they have the means to do so.
I wonder how much of a role this plays in the dominance of the acute care model in addiction treatment. I also wonder to what degree the seductive power of the diagnostic process and boredom with disease management might lead to finding additional things wrong with patients.