Tuesday, November 19, 2013

When fixing it ain't worth it

Like most physicians, I was initially drawn to the field of Medicine due to the profession’s blend of compassionate care and the intrigue of very nerdy science (human physiology/pathophysiology).  It is one of the only professions that allows one to apply scientific knowledge to relieve an element of human suffering. The majority of our training teaches us to identify a disease processes and "fix it" with the best "tools" available. Unfortunately, the "tools" we use as physicians all come with a long list of side effects and, at times, unwanted outcomes. During my Geriatrics rotation I experienced a different paradigm of practicing Medicine, which was refreshing. The ultimate goal remained the same; to alleviate a patient's suffering with the tools at hand. The difference in the approach was simple, "is it worth fixin'." Ultimately, a patients quality of life should always be the focus of our treatments. At times the possibility of fairly common side effects can outweigh the benefits, especially in the elderly.

While in clinic or visiting a NH, I found myself drawn to suggest an more aggressive therapy when presented with most clinical problems. I was able to recognized this near reflexive response I have developed during my training. It was nice to take a step back, evaluate the long term effects of the said therapies in the Geriatric population and ask the patient...... is this treatment worth it?  Many times the standard treatment recommendation just simply wasn't.

-- Benji Mulloy

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