Jon

Abraham- If you look at my concept of the neighborhood clinic, you will see that it is built on a “home care” approach without actuall going to your home. But the idea is to decrease costs by using a form of “symptomatic triage” and moving from the bottom to the top of the ladder and not just jumping top the top because it gets the hospital more money.
Thanks for the comment.

Hypatia- Great Question! The archives are indexed on a weekly basis rather than by date of post. If you are looking for a specific date, click on the weekly archive date of that closest preceded your desired post. For instance, to read the posts from 1.4 & 1.5, you would click the archive for 1.2.2005.

Not to worry though. Soon I’ll post a table of contents to help alleviate the ever growing archive list.

Thanks for the interest and for dropping by. Hope you enjoy what you find!

Windspike- You make several good points, that mirror some of what I propose. Our system is backwards with regards to new doctors working long hours in ER centers. Their inexperience may save the for-profit hospitals some bucks, but at the expense fo their patients. The motive should be care above profit. Also, coupling their inexperience with sleep deprivation is a ridiculous formula. No wonder they’re using it! No Common Sense…

Thanks for the thoughful contributions to this post.

David- I once lived in a small, one-hospital town that people “in the know” would glady travel 150 miles to avoid. From misdiagnoses to poor treatment to less than pleasant staff, it was a nightmare. I can’t tell you why it was this way, only that it was.
The number of facilities should be proportionate to the population they serve. We don’t need them to cost hundreds of millions of dollars to be effective either. Not as much as we just need them.
Thanks for dropping back by.

Laane- I fully agree that people need to learn to recognize what illness is “doctor-worthy.” In our era of non-prescription remedies and preventive health education, we should have at the very least some self-litmus test that says, “Time to see a doctor,” or, “You can handle this one.”
Breaks and gashes and unknown. prolonged illness do need attention, but certainly not every stomach ache or bruised knee.
Thanks for the comment.

Stormwind- Glad to have you drop by. Yes, there is a lot of ways to seek improvement if we just move a bit outside the parameters of the current stagnant conversation. i don’t think what I propose is in any way revolutionary, except that I am actually proposing it, instead of searching for a way to maintain the status quo while altering only the appearances.

Agreed that there is a dangling element regarding costs of care for long term or serious illness- always another element to consider.

Glad you enjoyed the psot. Hope you drop by again.

The same problem there: 2 days in advance making an appointment.
He doesn’t work from 17.00 till 8.00.
We have to a kind of family phycisians center..
That’s about an hour away by buss.
We have no car, so that means an expensive taxi. And a dr. who knows nothing about me.

To be short: this doesn’t work either.

People have to take more responsibility for their own health and should be able to see if one really needs a doctor’s help.

I hardly went with my children. Not for a cough, not for a children’s disease. No need.

God Bless America, God Save The Republic

A preliminary question, which you raise, but don’t necessarily center the post on is the number of Doctors, or as I like to put it, the pipeline to becoming a qualified physician is seriously constricted, if not broken.

On of the most troubling situations about the whole medical industry, at least in my book, is how Doctors are educated and trained. In a addictive fashion, hospitals lean heavily on undertrained pupils to staff their buildings for 30 plus hours at a stretch. These residents, appropriately tittled, I might add, are theoretically supervised by a thoroughly trained and licensed physician. Unfortuantely, at the tail end of yet another 30 hour shift, these medical students are very prone to making mistakes.

So,a patient should be necessarily interested if they are entering into a hospital, how long the person attending them has been awake. Ask them before you accept their care! Request a new physician that has gotten some sleep before you accept the care, if you are capacitated enough to think about this while sick or injured.

So, where does this lead my thinking? The idea that there are less rather than more physicians out there has to do with the gatekeeping functions that are used to keep the medical professions at their elevated and elite status within our capitalistic system that supports the industry. The less doctors there are, the more they cost to get them to work on you. There is a basic supply and demand curve working here. Also, the hospitals are co-dependent on the cheep labor provided by medical students and so they chew them up and spit them out only sporadically.

What we need is a new system of training medical professionals such that it opens rather than constricts the pipeline thereby increasing the number of doctors to reach a broader community, and if the supply/demand curve works in both directions, shrink the cost of quality care.

We also need to stop stretching the use of residents to serve the hospital bound population beyond the elastic snapping point. Doing so could prevent a myriad of medical mistakes from happening.

As you can tell, this is a wide ranging comment with only the suggestion of a solution rather than a concrete plan because we really haven’t touched on the structure of teaching hospitals and the universities that support them. There is no end to the complexity of the problem and it will require an equally complex solution.

Blog on brother.