More Health Care Musings

While I was riding the train to work this a.m., I was reading an article in the 8/13-8/20 New Yorker entitled Big Med in which the author, a Dr, analyzed how CheeseCake Factory ran its kitchens and compared that to the manner in which health care is delivered.  I have not finished the article yet but as you might imagine he is discussing the need for care to be coordinated, fixated on delivering useful care in the most efficient fashion, and not surprising, illustrating the manner in which neither is being done presently.

On the more optimistic front, he has already stated that hospitals are becoming more like chain stores and, in response to prompts in ObamaCare, are starting to try and figure out how they do these things in a more efficient manner.

But then on my train, a man who could not get a seat (nor did I have one) suddenly collapsed.  I saw the nurses, and maybe a Dr, on the train assemble and start to service the guy without any regard to malpractice concerns.  I was shaken by my own lack of any useful knowledge as to how to help the individual other than stay out of the way and near tears that people who could help were there as fast as possible.

I then overheard some people discussing the situation later.  They apparently knew the individual and were witness to the collapse.  He apparently has Parkinson's Disease, but was not exhibiting the signs of it prior to the collapse.  My thoughts at that point ran to the fact that when the EMS got him to an ER, he was going to be subject to all kinds of tests and some insurance scheme was going to pay for them.  To What End?  His Dr in the suburbs could probably tell them what specific tests to run and keep it simple.  What should have cost the system $1,000 or so, will probably cost the system $10,000 or so.  This what we need to find a way to end.  Have the Dr's who know a patient consult with the Dr's who are treating the patient so patient history has an immediate effect on what is done for the patient rather than having to run a whole battery of tests to reconfirm the patient's status because they ended up in a different hospital.