I think the extreme complexity of medicine has become more than an individual clinician can handle. But not more than teams of clinicians can handle.
If you're getting different prescriptions from different doctors, there has to be some sort of check and balance in there somewhere.
For patients to be safe, we need doctors to be able to reflect completely openly and freely about what they have done, to learn from mistakes, to spread best practice around the system, to talk openly with their colleagues.
The patient must combat the disease along with the physician.
The psychiatrist must become a fellow traveler with his patient.
In any operation, what you have to do is to persuade the patient to grant access to the patient's energy. The purest form of that is when you're trying to help a woman through labor: when you're saying, 'Push, push!' and you're rhythmically with the woman.
Just using a checklist requires [doctors] to embrace different values from ones we've had, like humility, discipline, teamwork.
I advocate for a totally new view of the role of the patient: patient as engaged partner, not passive recipient.
At medical centers such as the Cleveland Clinic and Kaiser Permanente, teams of doctors and nurses provide coordinated care while working for salary instead of getting paid for every procedure.
Our contention is not that medication alone is the answer. We really need to have it in conjunction with cognitive behavioral therapy and with peer support. And that needs to be reimbursed [by health insurers], because it shows huge reductions in overall spending.
Health care historically has been a very siloed field that's organized around medical specialties - urology, cardiac surgery, and so forth - and around the supply of these specialty services. The patient is the ping-pong ball that moves from service to service.
There's an opportunity for the pharmacist to play a much greater role in health care, especially with what we have going on in this country with the shortage of primary-care physicians.
There's a culture inside the NHS that is highly paternalistic. You know, 'We give them the service and they are grateful.' We have to move to shared decision-making.
Our babies are like penguins; penguin babies can't exist unless more than one person is taking care of them. They just can't keep going.
Have a hand in your own treatment. I have nothing but praise for our doctors, but I think they could help us better, and we can help them if we work together.
