It\’s interesting to see how different things are over at The Health Care Blog.  First, it\’s different to have to write \”health care\” instead of healthcare.  I personally am all for not using up or resources by adding the space between the two words.  Ihaveconsideredeliminatingspacesaltogether, but it gets confusing.  Iwon\’tdothat.
One of the big differences I see is the perspective of the readers and commenters.  I write here for a group of people I largely consider friends, cohorts, or at least sympathetic to my cause.  After all, people are coming here by their own volition (I assume nobody is getting this blog forced upon them as some sort of punishment, although that may be a bad assumption).  But the readers at THCB (as we insiders call it) are much more argumentative and much more likely to be \”experts\” in the area of healthcare delivery.  Certainly the other folks writing there are far more sophisticated than me (not that that\’s a hard thing), and are much more well-read in the area of HC reform.  The debates in the comments section are quite stimulating, although sometimes you have to wipe a little blood off of your screen.

What has struck me, however, is the entirely different perspective I have from most of the people they are reading.  I am a practicing physician, and so I know the HC system intimately (I am using \”HC,\” by the way, to save even more pixels).  I deal with it every day.  I speak with patients dealing with it every day.  I suffer the consequences of policies.  I have an enormous stake in the whole debate about reforming the system.  The other \”experts\” these people are reading are certainly worth listening to; they have a knowledge base that I can\’t rival.  But seriously, who knows more about baseball: a player or an analyst?  Does Derek Jeter know more about baseball than Peter Gammons?  If Jeter wrote a column about his knowledge of the sport, would it be worth reading?

I think this is yet another example of the importance of medical bloggers.  Up to now, the debate has been left to the \”experts\” and the people who read their stuff.  Up to now, doctors, nurses, and patients have been largely represented by proxy.  Blogging changes that.  Blogging lets the alternative perspective be heard.  Blogging shows where the theories of the \”experts\” succeed or fail in real life.  Medical blogs are not only of value, they are a crucial part of the debate.

I am not saying that our perspective is more valid than the \”experts.\”  I would probably trust Peter Gammons\’ knowledge in many areas of baseball over Derek Jeter\’s.  But a view of the debate that ignores the reality of what goes on in the hospital, pharmacy, and in the exam room is highly flawed.  The debate over HC reform is not just a theoretical discussion; it\’s not just a political squabble.  The debate over HC reform is personal to anyone who is in the system, either giving or receiving care.

So I welcome the addition of many new bloggers to the medical blogging community (I find it impossible to keep up with them).  I hope their voices continue to rise and be heard more and more.  I hope their perspective is not only put out in the mainstream, I hope it is actually listened to by those who have to act on HC reform.  Yes, politicians, I am talking to you.

I laugh when the commenters at THCB criticize the incomplete nature of my posts.  When I post, I am usually trying to make a point, not to give a complete discourse.  Even if you read my entire blog, you wouldn\’t get a complete perspective on the issue (although you may require years of psychotherapy to be able to re-enter society).  In the same way, a debate among experts is incomplete.  The experts are important, but without the real perspective of those who live their theories, the talk is no more than a lively debate (give or take a little blood-letting).

To fix this problem, we need all hands on deck.  We need everyone\’s expertise.

4 thoughts on “Expertise”

  1. I've said before that yours is one of the very few medically oriented blogs I can stand to read consistently. I think your comments in this post speak to much of why that's so.

  2. Dr. Rob, I couldn't agree with you more. What I find most alarming is that we're living in a world where an M.D. is not considered an expert in healthcare. I had my six-month checkup with my oncologist yesterday and he told me that the number of his patients being denied treatment by insurance companies for “orphan cancers” and even something as common as colon cancer has jumped from 2 or 3 to something like 25 or 30. Apparently the recommendation of an oncologist who serves on a Mayo Clinic board is not good enough for them, and whoever their “expert panel” is. We should all be very afraid. And you said it–we need to keep after the politicians–and the mainstream journalists too. I plan to tell my local paper's healthcare beat writer about this alarming trend. Thank you for keeping the drumbeat rolling.

  3. If you're interested in arcane policy discourse, then go wonk at THCB. If you want to reach into the guts of the profession, then go with us blogging grunts.

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