In a message dated 98-07-25 09:30:33 EDT, you write:
>
> > Some of us
> > feel that quantitative measures even if given subjectively by the patient
> can
> > be used as data and used for outcomes. Others feel that only data we
> measure
> > ourselves can be used since it can not be altered by the patients
> subjective
> > reports.
This is a wonderful example of the difference between treatment and
caregiving. It makes it clear that the problem with strict protocol is that it
seeks only to deal with the disease process while the patient is at least
equally interested in the disruption of their life. Treatment attends almost
exclusively to the former while caregiving embraces both. Outcome studies that
insist we rely upon only what the therapist can measure fail to take this into
account, and potentially lead to treatment that is generic, arid,and lacks
simple human diversity. This is the "medicine of the future" that the HMOs
prefer we practice for obvious reasons.
Put more simply, "Who cares what the patient thinks?"
Barrett L. Dorko P.T.
<A HREF="http://qin.com/dorko/">"The Clinician's
Manual"<http://qin.com/dorko></A>
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