Word: patient
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Dates: during 2000-2009
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...More In the years since the reviled health-maintenance organizations (HMOs) were at their peak, all manner of fixes have been proposed to the health-care system, from small tweaks to wholesale overhauls. There's pay-for-performance: compensation depending on doctors' success in keeping costs down and getting patients well. There's episode care: a fixed price for a procedure like a heart bypass that covers everything from pre-op to surgery to full recuperation. Most broadly, there's global care, which provides access to a diverse team of caregivers who cover all of a patient's needs...
...doing things is most graphically illustrated. Surgery in the U.S. is billed the same ŕ la carte way primary care is: separate charges for the hospital, the anesthesiologist, the lead surgeon, the post-op checkups, and on and on. Care itself can be similarly fragmented, with patients finding themselves in the hands of whoever happens to be on duty at any point in the day and a doctor on the night shift knowing little about a patient whose surgeon worked the day shift. Dr. Alfred Casale, Geisinger's chief of cardiothoracic surgery, tells stories of surgeons who don't even...
...Steele decided to fix this, switching Geisinger over to a prix fixe, episode-care model for surgery, starting with the heart bypass. Under the new system, a closely coordinated team of caregivers would be responsible for every stage of a bypass patient's treatment and recovery. The hospital would submit a single bill for all work and include a 90-day warranty. If a patient checked back in with a complication like a postsurgical infection, that work would be on Geisinger's dime. "We'll do it right, or we won't send a bill" was how Steele...
According to Abraham C. Verghese, a Stanford professor of medicine who has authored books that stress the importance of bedside exams, the doctor-patient relationship is like a ritual: “one individual comes to another and bares their soul and their body,” he says...
Samuels says he continues to carry around a black bag as a symbol of the doctor who sits by the patient and is able to pull everything he needs out of his bag without the patient worrying about issues like the cost-effectiveness of the procedure or whether the doctor is in “cahoots” with a pharmaceutical company...