We expect a level of perfection from our doctors, nurses, surgeons and care providers that we do not demand of our heroes, our friends, our families or ourselves. We demand this level of perfection because the stakes in medicine are the highest of any field — outcomes of medical decisions hold our very lives in the balance.
It is precisely this inconsistent recognition of the human condition that has created our broken health care system. The all-consuming fear of losing loved ones makes us believe that the fragile human condition does not apply to those with the knowledge to save us. A deep understanding of that same fragility forces us to trust our doctors — to believe that they can fix us when all else in the world has failed us.
I am always surprised when people say someone is a good doctor. To me, that phrase just means that they visited a doctor and were made well. It is uncomfortable and unsettling — even terrifying — to admit that our doctors are merely human — that they, like us, are fallible and prone to bias. Continue reading The Good Doctor →
JANET DUNI has a tiny office and a wide reach. From her desk in the heart of Vanguard Medical Group in New Jersey she combs through data, helping to co-ordinate care for thousands of patients. She checks on those who have recently left hospital, for example, and tries to encourage best practice among the staff. Thomas McCarrick, a primary-care doctor and chief medical officer, is grateful for Ms Duni’s help. Working with her, he hopes to lower costs, see more patients and keep them well—the holy grail of American health care. But Ms Duni is not Vanguard’s employee. She works for an insurer.
Beneath the interminable squabbles over Barack Obama’s health law, a transformation is taking place. To date most doctors have been rewarded for providing more rather than better services. This is unsustainable. Health care gobbles nearly 18% of GDP. Now a myriad experiments are under way, as described in the newest issue of Health Affairs, the wonk’s Bible. Some programmes are prodded by Mr Obama’s reform. Others are independent of it. But they share a common goal: pushing doctors and hospitals to provide better, cheaper Continue reading Health care service – The good old ways! →
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