OT: How Do We Heal Medicine?

I've read all of Atul Gawande's books on medicine, which I think are outstanding. The topics of doctors, healthcare costs, insurance, medical decisions and the inability of the medical systems to give us what we need and want come up frequently on this forum.

Dr. Gawande was recently hired to manage a new healthcare insurance and medical management system started by Amazon, Berkshire Hathaway and JP Morgan/Chase. I've been thinking about this and thought that some of you may be interested in one of Dr Gawande's TED talks:



/www.ted.com/talks/atul_gawande_how_do_we_heal_medicine

Interesting.

So we have now gone from medical care in the past delivered by the independent, autonomous, self-reliant "old country doctor" type, who did it all, but maybe not all of it expertly, to the modern "pit crew" team approach, with specialists in abundance, each of them giving us great care, but only in his or her own narrowed specialty.

Gawande even cites figures of around two providers per patient in the past, moving up to around fifteen per patient in more recent times, evidence that supports the advent of the team process that he describes.

What surprises me, though, is that he doesn't really address an obvious result of this team process: namely, that the patient now gets fifteen bills instead of two.

Certainly one of the reasons why medical costs have risen in the "team approach" era.

the only way to fix "medicine" is to put me in charge of everything.

Normal59 said...
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I think a couple folks missed Gawande’s point: we need to develop the pit crew mentality (as he successfully did in 8 hospitals around the world) specifically for containing cost. And by the way, there were ancillary benefits which resulted, too.

Yes, you are correct about Dr Gawande's point. His book, The Checklist Manifesto fleshes this idea out in more detail.