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Between the data and the deep blue sea
Published in John Spiers, Philip Booth, Who Decides Who Decides?, 2018
We need individually financially empowered real choice and incentives to align professionals, patients and opportunities. And we need good published and audited information to optimise comparisons, choice and quality. This needs to be physician-specific and patient-specific. This is in some respects difficult, but it is not impossible. Indeed, in America there are very instructive models which we could follow. The Foundation for Accountability (FACCT) began in 1995 to design programmes to measure the results of care, medical practice and the consumer’s experience. The project has been developed, tested and validated for a number of conditions, including breast cancer, diabetes, major depression, asthma, HIV/AIDS, child care and care at the end of life. Nursing homes ratings have been published since 2002. The National Quality Forum is a statutory organisation to develop reporting standards. Most states have published good data, as have several private purchasing consortia. The National Committee for Quality Assurance (NCQA) – an independent agency – publishes a set of some 60 ‘effectiveness of care’ indicators. Online doctor directories include patient ratings, too. Some, such as the Massachusetts Health Quality Partners, are developing methods for evaluating individual physician performance. Care Counsel provides expert advice on nurses to consumers. Consumer’s Medical Resource enables consumers to get expert second opinions on their physician’s treatment recommendations.52 We can have it, too, if we really really want it.
Suicide-Related Internet Use Among Suicidal Young People in the UK: Characteristics of Users, Effects of Use, and Barriers to Offline Help-Seeking
Published in Archives of Suicide Research, 2018
Jo Bell, Katherine Mok, Eric Gardiner, Jane Pirkis
Finally, further reasons for not seeking help from offline sources (or anyone) were reported. These included social anxiety and lack of trust and confidence: I think I need medication, but initiating this kind of conversation is awkward. I wish there was an online doctor, but I don’t know if I would even feel comfortable picking up a prescription. Most of all, I don’t feel I could fully put across my feelings in a face-to-face situation, to write things down in an instant messenger form would make seeking help so much easier … just being able to be clear with my thoughts in my head and not feel rushed to speak and like I’m talking too much. I can’t cope with people.I’m scared to. It takes a lot of effort and courage and bravery, and when you feel suicidal you don’t feel like getting help from anyone.Zero confidence.