• Home
  • About
  • Blog
  • SMART
  • RunSmart
  • Podcast
  • Innovanated
  • Mobius
  • FAQ
  • Contact

Paternalism And The Demise Of Health Care

Thursday, 08 August 2013 22:11

Pointing fingersClinicians like to think they know what is best for the patient. And oftentimes, that is true. I mean, isn't that why patients come to see us?

But there is a fine, yet distinct, line between patient-centered care and paternalism. You know, the "father knows best" mentality that pervades our health care system right now. It might have been fine in the 1950's, but patients of the 2000's are becoming consumers when it comes to their health care. And rightfully so.

If we don't start paying attention, paternalism will be the demise of health care as we know it. And maybe that's a good thing.

Paternalism, by definition, is

"Behavior, by a person, organization or state, which limits some person or group's liberty or autonomy for their own good. Paternalism can also imply that the behavior is against or regardless of the will of a person, or also that the behavior expresses an attitude of superiority."

Back in the 1950's, physicians were the hub of patient care. They were the only show in town. They made house calls. Add to that the behaviors of many groups, organizations, and states that drove the health care environment. We were told these behaviors were for the best interests of patients.

So it is to this day.

Many groups continue to promote a paternalistic agenda disguised as "patient safety". Most states continue to have paternalistic health care laws which limit personal autonomy. All of this assumes that someone other than the patient knows what is best for the individual.

But we are now in a new era. It is an era in which patients are demanding to truly be a part of the decision-making process. They want to be able to make choices regarding their provider and how they access those providers. They are coming in to clinical visits armed with the latest data from the Internet, and oftentimes it is the same data that clinicians should be (or have been) reading.

Google and PubMed have become wonderful places for patients to explore options. When 35% of Internet users are online not just for health information but to self-diagnose, then we have to officially consider the health care world a different place. They have the capacity to make informed decisions, and they choose to do so for their own best interest.

The roles have changed. Or as Dylan once said,

"For the loser now / Will be later to win / For the times they are a-changin'"

These changes, however, won't come without a fight. All of this forces the powers-that-be to relinquish power and control. Be warned, because paternalism, which has a stranglehold on health care, simply doesn't fit well with a patient-centered model of care.

Paternalism is ultimately a limiter to personal autonomy. The battle lines are drawn - and something has to give.

Photo credits: Newtown grafitti

Related Articles By Allan Besselink
  • When Do Health Care Consumers Just Say No?
  • Health Care Needs A Few Angry Moms
  • It's All About The Patient

Free Updates

Join The Smart Life Revolution!

Latest Blog Posts

  • The Enlightenment of 2020
  • Run Towards Or Run Away?
  • Simplicity And Civility
  • Back In The Saddle Again
  • A Pause For Many A Cause

Blog Categories

Smart Physio

posts are on professional and career-related topics such as health, fitness, training, and health care.

Rhubarb Diaries

posts are commentary, perspectives, opinions, humor and insight on all of my favorite topics: music, sport, and politics/current events.

Most Popular Posts

  • The Deafening Silence
  • Evolution Or Revolution?
  • Learning How To Live
  • The Homeostasis Of Writing
  • McKenzie’s Derangement Syndrome In A World Of Pathoanatomy
  • Three Common Examples Of Self Image, Self Sabotage, And Comfort Zones In Action
  • Patient Access To Physical Therapy And Groundhog Day
  • Why HB 1263 Matters
  • The Flow Of Running, The Flow Of Life
  • One Nation – Under Gold

Top 10 Smart Physio

  • The Deafening Silence
  • Evolution Or Revolution?
  • Learning How To Live
  • The Homeostasis Of Writing
  • McKenzie’s Derangement Syndrome In A World Of Pathoanatomy
  • Three Common Examples Of Self Image, Self Sabotage, And Comfort Zones In Action
  • Patient Access To Physical Therapy And Groundhog Day
  • Why HB 1263 Matters
  • The Flow Of Running, The Flow Of Life
  • A Pause For Many A Cause

Top 10 Rhubarb Diaries

  • One Nation – Under Gold
  • The Paradox That Is World Cup Soccer
  • Rhubarb Ruminations: Episode 3
  • Longhorns Update: Missing In Action
  • Rhubarb Ruminations: Episode 2
  • Stay In School - And Work On That Jump Shot
  • The First Amendment And Fanaticism
  • One Small Step For Man … One Huge Step For Thought
  • Rhubarb Ruminations: Episode 5
  • The Tifosi Are Coming! Formula One Heads To Austin

PT Blog Awards

Top 5 finalist in three categories: "Best Overall Blog", "Best PT Blog" and "Best Advocacy Blog".

Official Site

Allan Besselink

Allan Besselink, PT, DPT, Dip.MDTAllan Besselink, PT, DPT, Dip.MDT has a unique voice in the world of sport, education, and health care, one that has been defined by his experiences as physiotherapist, mentor, McKenzie practitioner, innovator, author, educator, coach, patient, and athlete. Read more about Allan, contact him, get updates via email, or connect with him on Twitter, Facebook, and LinkedIn.

RunSmart Book

Where To Buy RunSmartUp to 60% of runners will sustain an injury within any given year. Poor running mechanics, in conjunction with poor, ineffective and outdated training methods, can pose a significant injury risk. "RunSmart" was written to address these issues in the running community.

Featured Chapter

Clinical Orthopaedic Rehabilitation "Running Injuries: Etiology And Recovery- Based Treatment" (co-author Bridget Clark, PT) appears in the third edition and fourth editions of "Clinical Orthopaedic Rehabilitation: A Team Approach" by Charles Giangarra, MD and Robert C. Manske, PT.

License

Creative Commons License
This work is licensed under a CC BY-NC-ND License.

Visitors

Copyright 2006-2020 Allan Besselink  | Terms Of Use | Privacy Policy |  Disclosure Policy |  FAQ

Powered By Mobius Intermedia