Download Chaos and Organization in Health Care by Thomas H. Lee MD, James J. Mongan MD, Laura Cushing-Kidney PDF

By Thomas H. Lee MD, James J. Mongan MD, Laura Cushing-Kidney

One of the main daunting demanding situations dealing with the recent U.S. management is overall healthiness care reform. the dimensions of the procedure, the variety of stakeholders, and ever-rising bills make the matter look nearly intractable. yet in Chaos and association in healthiness Care, prime physicians provide an positive diagnosis. of their frontline paintings as companies, Thomas Lee and James Mongan see the inefficiency, the overlooked possibilities, and the occasional damage that could outcome from the present procedure. the foundation reason for those difficulties, they argue, is chaos within the supply of care. If the matter is chaos, the answer is association, and during this well timed and outspoken e-book, they give a plan.

In many ways, this chaos is as a result of whatever solid: the dramatic growth in clinical science--the explosion of scientific wisdom and the exponential elevate in treatments. Imposed on a fragmented method of small practices and person sufferers with a number of services, growth ends up in chaos. Lee and Mongan argue that attacking this chaos is much more vital than no matter if overall healthiness care is controlled through govt or managed via industry forces. a few companies are already tightly equipped, adapting administration ideas from enterprise and supplying care that's by way of many measures more secure, higher, and not more high priced.

Lee and Mongan suggest a number of concepts that may be followed national, together with digital clinical documents and knowledge structures for sharing wisdom; team-based care, with medical professionals and different companies operating jointly; and illness administration courses to coordinate deal with the sickest patients.

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This fragmentation is not limited to the components of our health care system; it also characterizes the way in which patients and their illnesses are viewed. To cope with the flood of scientific knowledge described in chapter 2, physicians are divided into increasingly narrow subspecialties defined by organs and diseases. Health insurers pay providers on the basis of individual physician office visits, hospitalizations, tests, and procedures—not the episodes of weeks, months, and years that actually define an illness.

9 4 What does a controllable lifestyle mean? In this study, having control over one’s work hours was critical to the definition, and other data confirm that younger physicians place a high priority on time for life outside work. These priorities are somewhat in conflict with the concept of the selfless physician willing to be there for his or her patient at any time or place. Still, these priorities are consistent with a modern society in which many physicians’ households have two working adults, and about half of graduating physicians are women, many of whom expect to start families.

If the problems with primary care were just the pay and the demanding hours, they might be addressed by expensive yet simple measures like paying primary care doctors more and reducing the number of patients that they see. The conviction is growing, though, that the problem with primary care may be the job itself. Primary care physicians are no longer the all-knowing healers of a generation ago. Instead, they spend much of their day managing an overwhelming flow of information—lab tests; requests for referrals, prescriptions, and the completion of forms; calls from patients and family members.

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