To err is human. Unfortunately, in our medical system, we expect that physicians are superhuman and therefore choose not to build the support and error reduction measures that would allow mere humans to competently practice high quality health care.
Having not built the systems to reduce errors, our hospitals and medico-legal system have decided that in addition, denying that errors happen is the best way to make them go away. In stark contrast to the principles of six-sigma, lean manufacuring, and other systems to reduce errors, the
medical system decided that it would instead announce the superhuman perfection of its approaches and allow those who thought otherwise to take them to court.
Per a recent article in the NYTimes:
For decades, malpractice lawyers and insurers have counseled doctors and hospitals to “deny and defend.” Many still warn clients that any admission of fault, or even expression of regret, is likely to invite litigation and imperil careers.
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The Nintendo and other game consoles have spawned a wave of inactivity– as kids picked up joysticks instead of sports equipment and settled into a couch to play with their friends.
Recent developments, however, have shown that consoles may now help engage families in healthy activities– and the Nintendo Wii Sports package and popular game Dance Dance Revolution appear to be leading the way in making athletics fun and social to those who aren’t traditionally “jocks”.
People using the Wii have gotten so engaged, that reports of “Wii-itis” have emerged in the literature of the weekend warrior.
Recently, the Wii has expanded its line of healthy entertainment with the Wii Fit.
Motivation is a key element in the Wii Fit programs. An on-screen graph tracked my progress, and I “stamped” each calendar day to show that I had exercised. Each minute of activity added a point to my Fit Bank, and enough points unlocked new activities; Wii Fit includes over 40 altogether. On-screen instructors demonstrated and joined me during yoga and strength-training exercises, congratulating me when I held my balance or noting that I stopped mid-exercise.
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Consumer-focused Care spoke with Gene Drabinski, Vice President of Cost and Quality for Trizetto, a leading enterprise software company providing solutions to health plans. As you may recall, we had an interview with another Trizetto executive, Dan Spirek, last year.
The interview took place at the World Health Care Congress and both a podcast and a transcript lay out the conversation below.
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Primary care and any thoughts of actually trying to do well by patients is again lost to the revenue politics coming from the RUC. As Happy illustrates, its basically a call for a Chronic Care Corps– where primary care physicians are asked to volunteer to care for sick people.
Some highlights (refer to Happy’s article for more details)
- 9.2 minutes per month per patient in physician time for a Tier 3 Medical Home
- RUC recommends a work RVU per patient per month of 0.35 for a Tier 3 Medical Home. In essence, you are paid $86 an hour, and that’s before you pay your over head. After overhead and taxes, you are lucky to take home $30 an hour
- All I have to say is, these are the folks who created the mess, and their trying to create a system that is “cost neutral”, that will pay for itself by not taking any money from their own specialties. It’s paying for itself alright. By punching primary care in the face.
Again, the policy wonks seem to think they can legislate sickness to go away and continue to push procedures over care coordination and engagement. 9.2/month for very sick people is a joke– I can’t even keep my hair in control (and I have an army cut) in the time they’re expecting a doc to serve as their patient’s health quarterback.
The RUC is hastening the death of primary care– soon however will rise new mechanisms to remove it from the stranglehold of the “insurance” shakedown racket.
Consumer-focused Care spoke with Kenneth Mays, Marketing Director for Bumrungrad International, a leading player in medical travel/ medical tourism in Southeast Asia, as a world class, JCAHO accredited (the American hospital accrediting organization) facility.
The interview took place at the World Health Care Congress and both a podcast and a transcript lay out the conversation below.
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