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March 17, 2009
Quality care
Yesterday, the latest issue of JAPS arrived. It contains an article by Dr. Terrell published posthumously. It will give readers unfamiliar with his work just a taste of the stupendous wisdom, wit and insight of the man. I happened across a discussion on-line of the concept of quality care, and found some good comments by Dr. Centor. But unfortunately, even this excellent discussion misses Dr. Terrell's main concerns. Knowledge of data is helpful, but not the main concern in medicine. This is because diagnoses are not discoveries, but decisions. Individuals should not be lost in the data. Quality medical care cannot be measured and standardized if the individual's suffering is the main point of concern. There are too many competing issues to standardize.
This article deserves wide, careful and repeated reading by anyone who has medical problems, or in the medical fields.
Posted by Robert Maddox at 4:21 PM | Comments (0)
March 10, 2009
Cramdown
Dr. Ed O'Boyle, a former business professor and now research analyst, has written an excellent summary in the local paper of the reaction of doctors to the various types of cramdown that have been problematic in medicine for decades. His wife is a pediatrician and he knows whereof he speaks. This is as concise a summary as I have seen of the personal level business decisions doctors have to make.
In order to preserve primary care, it seems that Obama will be forced to make that final socialist step making all primary care doctors employees of the State. Hitherto, under our current fascist system, we are being made employees of corporations controlled by the State. Currently, that control is exercised by reimbursement, increasingly out of the hands of the patient. In order for a single payor system to work, these various responses to cramdown will have to be limited.
Posted by Robert Maddox at 6:40 AM | Comments (0)