Ask a Question

You visited our site and still have questions? Feel free to contact us

Consultation and guidance given not in the framework of service does not serve as a replacement for a physician’s examination or consultation, and is not considered a “medical diagnosis” or “medical opinion". In all cases of urgency, distress or emergency (physical and/or mental), seek medical care with a family doctor, closest emergency room, and/or ambulatory service.   

Start service

Share

Terms of use

Medix FTP Service (the "Service") is designed to provide you with an easy way to transfer files relevant to the management of your case to Medix Medical Services Europe Limited ("Medix", "we" and "us").

 

The following terms and conditions together with the Medix Information Security Policy (which may be found at http://medix- europe.com/Information_Security_Policy.aspx) (together, the "Terms of Service"), form the agreement between you and us in relation to your use of the Service. You should read the Terms of Service carefully before agreeing to them. If you do not understand any part of the Terms of Services, then please contact us at axa-ppp-intl@medix-europe.com for further information. You acknowledge and agree that by clicking on the "Upload" button, you are indicating that you accept the Terms of Services and agree to be bound by them.

 

Using the Service

 

In order to use the Service, you will be required to log in by submitting your member number which was provided to you by the Medix staff, your name and e-mail address. Once you have logged in, you will be able to upload files to the Service. We will download your files to our system and no copy will be retained on the server used to provide the Service. For detailed upload instructions, please click here.

 

Protection of your information

 

We take the safeguarding of your information very seriously. In order to prevent unauthorised access or disclosure of your information we have put in place appropriate physical, electronic and administrative procedures to safeguard and secure the files you upload to the Service. However, no method of transmission over the internet, or method of electronic data storage is 100% secure and while we have put in place appropriate protections, we cannot guarantee the security of information you upload to the Service.

 

Quality and availability of the Service

 

While we make reasonable efforts to provide the Service, it is provided "as is" with no representation, guarantee or warranty of any kind as to its availability, functionality, that it will meet your requirements or that it will be free of errors or viruses.

 

We will not be responsible for any damage to your computer system or the computer system of any third party resulting from your use of the Services where such damage is caused by circumstances which are beyond our reasonable control.

 

I agree
close
Start service
Start service

Does your mom really need this operation?

10/15/2014 | By: Medix team

The current surgical decision making puts the surgeon in the center. Why and what can we do about it?

We would all like to believe that we are making the right choices, when sitting in a surgeon’s office and asked to agree to a certain operation for us or for a family member. Can we really make an informed decision?

 

For the most part, a decision is made following a discussion between the patient, his family and the surgeon himself. At times other specialists are consulted, such as cardiologists or nephrologists, however their role is more limited and focuses on clearing the patient for a procedure rather than giving input regarding alternative treatments. As a rule, a surgical consultation is the first time a surgeon will come into contact with the patient, meaning that a lack of understanding of the patient’s circumstances and preferences is inherent in this approach. The centrality of the surgeon in this process seems intuitive but in many cases the patient is lost in the fray. After all, surgeons are trained interventionists who aren’t necessarily prepared to properly present non-surgical treatment options, effectively barring patients from opting for one of these alternatives.

 

Yet this approach may be sub-optimal for many high-risk patients such as elderly people  facing decisions about major surgery. Studies published in the New England Journal of Medicine (NEJM) have revealed some concerning statistics. Taking a colectomy procedure as an example: 30% of nursing home patients which undergo this surgery die within three months after surgery and 40% of the survivors suffer a decline in functional status. Twelve months down the road and the reality is worse, with 50% mortality and 50% impairment among survivors.

 

In stark contrast to these figures, one third of elderly Americans undergo surgery during the final year of their life and three quarters of seriously ill patients state that they would opt out of life sustaining treatment if it resulted in serious cognitive or physical impairment.

 

So what can be done? Over the past years, the importance of a patient centered approach has been promoted by many medical journals. This approach has manifested itself in multidisciplinary teams comprised of a number of specialists who are meant to discuss the different aspect of a case and present the patient with multiple options and explanations regarding the advantages of each path. One field in which this has been widely implemented is oncology, with meetings called tumor boards becoming common practice.

 

The article in NEJM believes that a similar approach can and should be implemented for surgical decision making in high-risk patients. After all, many of the issues are the same; dealing with co-morbidities, multiple treatment options including “watchful waiting” and the need for taking into account the patient’s wishes and priorities with regard to quality of life.

 

"Evaluating recommendations, and articulating the benefits and risks to patients comprehensibly require more than a well-informed or experienced surgeon. Meetings these needs may require teamwork among physicians, nurses and non-clinicians like social workers" says the article. "Currently, such teamwork typically occurs on an ad hoc basis, if at all. But they should meet regularly to present and discuss high-risks cases. Achieving the best outcomes in the sickest and most frail patients 'takes a village'. It's difficult to create such a team through an ad hoc enterprise that begins the day of an operation and continues piecemeal from the early postoperative period until hospital discharge.  Ideally the team would have experience working together to coordinate preoperative assessment, intraoperative care, rehabilitation and recovery".

 

When making medical decisions, whether personally, or for your mom, there is a salient struggle to balance between curative treatments, and quality of life. This delicate balance is one that we all strive to master, so what better situation is there to start thinking critically and creatively about accepted medical practices?

By continuing to use this site you consent to the use of cookies on your device as described in our cookie policy unless you have disabled them. You can change your cookie settings at any time but parts of our site will not function correctly without them.

ok