At the Massachusetts Medical Society’s 8th Annual Leadership Forum last Wednesday, Dr. Steven Schroeder, former head of the Robert Wood Johnson Foundation
and Distinguished Professor of Health and Health Care at the University
of California, San Francisco, told a provocative story about a poll
that asked patients in the U.S. `Canada, Australia, New Zealand and
the U.K the following question:
“If your personal doctor told you that you had an incurable and fatal
disease, would you accept that diagnosis or seek a second opinion?
- In the U.S. 91 percent of patients said they would seek a second opinion.
- In Canada 80 percent “ “ “ “ “ “ “
- In Australia 71 percent “ “
- In New Zealand 51 percent
- In the U.K. 28 percent
“You have to love the British,” Schroeder commented. “You can just hear
an Englishman saying ‘Well, Luv, it’s been a good life, hasn’t it? Now
let’s make a pot of tea and discuss the funeral arrangements.”
At the other end of the spectrum, we find the Americans who, Schroeder
noted, “are the only people in the world who expect to live ‘in
Today, I would like to suggest that our expectations as patients help
to explain why we spend roughly twice as much per person on health care
as most developed countries—even when, overall, it’s not clear that our
healthcare is better. In fact, in some areas outcomes are worse.