There should be no doubt whatsoever that the voice and the insights of primary care physicians need to be heard loud and clear if the United States has any hope of solving the maddening increases and waste in our system. We have spent far too much time creating a system oriented to excesses and unnecessary outlays for health care. It’s time for a return to common sense and medicine delivered in a true physician-patient setting. Our primary care doctors don’t have the time needed to be at their effective best and we need to fix that.
I am anxious to be a part of dialogues with all forward-looking physicians like Dr. Young.
There should be no doubt whatsoever that the voice and the insights of primary care physicians need to be heard loud and clear if the United States has any hope of solving the maddening increases and waste in our system. We have spent far too much time creating a system oriented to excesses and unnecessary outlays for health care. It’s time for a return to common sense and medicine delivered in a true physician-patient setting. Our primary care doctors don’t have the time needed to be at their effective best and we need to fix that.
+1
There should be no doubt whatsoever that the voice and the insights of primary care physicians need to be heard loud and clear if the United States has any hope of solving the maddening increases and waste in our system. We have spent far too much time creating a system oriented to excesses and unnecessary outlays for health care. It’s time for a return to common sense and medicine delivered in a true physician-patient setting. Our primary care doctors don;t have the time needed to be at their effective best and we need to fix that.
+1
+1
There is certainly merit to Dr. Gawande’s opinions about the importance of consistency and checklists. He is a surgeon and this makes more sense in the world of the surgeon or the ICU. In high-risk high-cost environments, where the problem being addressed is essentially the same for every patient (not much variation from gallbladder to gallbladder) this approach works.
However, this approach often doesn’t make sense in primary care. One of the ways family physicians deliver better care at a lower cost is that we are flexible and negotiate with patients about all of the trade-offs and complexities of their lives. Acute and chronic care guidelines are often very helpful, but there are many individual patients for whom they make no sense. There are many patients who received all the guideline-driven care, but who still are not at treatment goals.
The world of the family physician is too complex and nuanced for the checklists Dr. Gawande supports.
There should be no doubt whatsoever that the voice and the insights of primary care physicians need to be heard loud and clear if the United States has any hope of solving the maddening increases and waste in our system. We have spent far too much time creating a system oriented to excesses and unnecessary outlays for health care. It’s time for a return to common sense and medicine delivered in a true physician-patient setting. Our primary care doctors don’t have the time needed to be at their effective best and we need to fix that.
I am anxious to be a part of dialogues with all forward-looking physicians like Dr. Young.
There should be no doubt whatsoever that the voice and the insights of primary care physicians need to be heard loud and clear if the United States has any hope of solving the maddening increases and waste in our system. We have spent far too much time creating a system oriented to excesses and unnecessary outlays for health care. It’s time for a return to common sense and medicine delivered in a true physician-patient setting. Our primary care doctors don’t have the time needed to be at their effective best and we need to fix that.
+1
There should be no doubt whatsoever that the voice and the insights of primary care physicians need to be heard loud and clear if the United States has any hope of solving the maddening increases and waste in our system. We have spent far too much time creating a system oriented to excesses and unnecessary outlays for health care. It’s time for a return to common sense and medicine delivered in a true physician-patient setting. Our primary care doctors don;t have the time needed to be at their effective best and we need to fix that.
+1
+1
Dr. Young,
I just listened to a TED talk by Atul Gawande. He calls for more of a systems/checklist approach to medicine. I would be interested in hearing your thoughts about what he had to say.
http://www.ted.com/talks/atul_gawande_how_do_we_heal_medicine.html
Ely
There is certainly merit to Dr. Gawande’s opinions about the importance of consistency and checklists. He is a surgeon and this makes more sense in the world of the surgeon or the ICU. In high-risk high-cost environments, where the problem being addressed is essentially the same for every patient (not much variation from gallbladder to gallbladder) this approach works.
However, this approach often doesn’t make sense in primary care. One of the ways family physicians deliver better care at a lower cost is that we are flexible and negotiate with patients about all of the trade-offs and complexities of their lives. Acute and chronic care guidelines are often very helpful, but there are many individual patients for whom they make no sense. There are many patients who received all the guideline-driven care, but who still are not at treatment goals.
The world of the family physician is too complex and nuanced for the checklists Dr. Gawande supports.