Word: carefully
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Dates: during 1970-1979
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These practitioners act as independent health-care consultants. Accepting "clients" who may be ill or just troubled, they play a role that sometimes seems to be a cross between Marcus Welby and Ann Landers. Insisting that "medicine is concerned with disease, nursing with health," they preach the gospel of preventive medicine-or "health promotion," as they call it. Says M. Lucille Kinlein, who runs a thriving practice in Hyattsville, Md.: "We give people an opportunity to think in a different concept, namely to think wellness...
...Manhattan's Bellevue Hospital Medical Center for twelve years, says that many young college graduates arrive ignorant of routine procedures. Says she: "These skills -let alone complex tasks-just are not easily mastered amid the tensions and emotions of a ward setting." Adds Rita Bellersen, a coronary-care nurse at Veterans Administration Medical Center in Seattle: "We're now telling patients how to rearrange their entire lives. But we're forgetting to change their beds and to bathe them...
Activist nurses contend that the real reason for this obstinance is that physicians want to hold on to their economic power. Many doctors admit that up to 80% of all office care given by pediatricians and family practitioners could be handled by competent nurses. Says Dr. Leon Oettinger Jr., a pediatrician in San Marino, Calif: "With its heavy reliance on physicians, the American medical system can be said to be using Cadillacs to do a tractor's job." That may not be the kindest analogy, but the Department of Health, Education and Welfare agrees with the basic analysis...
...aware of what they don't know. Nurses and doctors ought to work together as a team, but I am concerned about the idea of a team without a team captain." For the patient, says Relman, the important issue is always "am I getting the best possible care?" It is also a question for those who will have to deliver that care...
...their money ($1,500 a page) where their mouths are. Former HEW Secretary Joseph A. Califano Jr. held forth for seven pages (paid for by Xerox Corp.) on the economics of aging, and Jimmy Carter was given two pages (on the house) to explain how the U.S. health-care system "rewards spending and penalizes efficiency...