The Lies We Tell in the Exam Room

New York Times - Views

Soon, medical practice will be practically perfect.

Or so one can only assume from the quantities of flow sheets, protocols and guidelines being churned out these days, all intended to transform health care into an instrument as sleek and reliable as a new transcontinental jet, floating through cloudless blue skies from Point Sick to Point Well.

Meanwhile, though, the actual enterprise lurches along like a noisy, crowded bus bumping through back alleys to the local flea market, a place where negotiation rules and even the simplest transaction can stall in a tangle of missed cues and crossed expectations.

The confusions that plague today’s medical care have so little to do with the vision of tomorrow’s smooth operation that no one pays them much mind. Yet they are likely to persist — little cracks in that big jet’s runway, particulate matter in its fuel — and we ignore them at our peril. Hence this new column, a monthly inspection of some of the irregularities on the road...