Dr Ladouceur’s editorial in the August issue noted that family physicians are often asked to provide an opinion about a patient’s prognosis, including how long a person’s disability will last, how long a person will need home care, and how long a person can remain independent in the community.1 He cited Downar et al,2 who followed patients whose doctors estimated they would probably die within a year. Two-thirds of the patients survived longer than a year. Dr Ladouceur concluded that physicians cannot predict a patient’s prognosis and wrote, “The most absurd aspect of this story is that ... physicians remain the most reasonably apt to establish prognosis.”1
Defending the Affordable Care Act in the United States, Sommers et al cited evidence indicating that the expansion of Medicaid (allowing people to go to a doctor) decreased the chance of dying, particularly from heart disease, infection, and cancer.3 About 280 people need access to medical care to prevent 1 death during 1 year.2 Millions of Canadians do not have a family doctor, partly because doctors are too busy filling out forms to take new patients.
I agree with the spirit of Dr Ladouceur’s editorial. I think it is absurd that bureaucrats demand we do something (ie, estimate prognosis) that cannot be done with the current state of knowledge. Our time would be better spent looking after patients.
Footnotes
Competing interests
None declared
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