Semper Paratus: Our Decisions About Emergency Care

Jessie Gruman

First published 4/20/11 on The Prepared Patient Forum 

Nora misjudged the height of the stair outside the restaurant, stepped down too hard, jammed her knee and tore her meniscus.  Not that we knew this at the time.  All we knew then was that she was howling from the pain.

There we were on a dark, empty, wet street in lower Manhattan, not a cab in sight, with a wailing, immobile woman.  What to do?  Call 911? Find a cab to take her home and contact her primary care doctor for advice?  Take her home, put ice on her knee, feed her Advil and call her doctor in the morning?

Sometimes it is clear that the only response to a health crisis is to call 911 and head for the emergency department (ED).  But in this case – and in so many others we encounter with our kids, our parents, our co-workers and on the street – the course of action is less obvious, while the demand for some action is urgent.

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Are We All Ready for Do-It-Yourself Health Care?

Jessie Gruman, PhD

First published 4/06/11 on the Center for Advancing Health blog.

The outsourcing of work by businesses to the cheapest available workers has received a lot of attention in recent years.  It has largely escaped notice, however, that the new labor force isn’t necessarily located in Southeast Asia, but is often found here at home and is virtually free.  It is us, using our laptops and smart phones to perform more and more functions once carried out by knowledgeable salespeople and service reps.

This was particularly salient to me this week: I spent an hour online browsing, comparing prices, reading customer reviews and filling out the required billing and shipping information to get a great deal on a new lamp.  An airline would charge me 99 cents to talk to a person but provides information for free online.  Calls to Amtrak to make train reservations are routinely answered with a message that the wait to talk to an agent is 30 minutes, but that I can book travel myself – plus get better deals – if I do it online.  My bank has a small staff, limited hours and it charges extra for paper checks and mailed hard copy statements… but its Website is welcoming and useful, even at 3 a.m.

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More Can Also Be Less: We need a more complete public discussion about comparative effectiveness research.

JESSIE GRUMAN

Originally Published 12/1/10 on the Prepared Patient Forum

Jessie GrumanMedia coverage of the government’s new investment in comparative effectiveness research leans heavily toward the effects of such research on new drugs and technologies: Will such evaluations lead to restricted access to the latest innovations?  Will insurance no longer cover a drug that might give my aunt another year to live? Will such research hinder the development of a drug that could cure my nephew of type 1 diabetes?

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