Word: patients
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Dates: during 1990-1999
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With doctors pressed to treat more patients in less time, "teaching slows you down and takes up space if the student wants to see a patient," he said...
...hospital stays become shorter and patients' conditions more chronic, it is less useful to have professors lecture about diseases and treatments to medical students gathered around a patient's bed, according to Tosteson...
...contracts competitive. With comprehensive records on the cost of every procedure, administrators know what kind of bid to expect from would-be providers--and what is too low to be realistic. Still, the competition to win contracts is so keen that the system's capitation rate--the cost per patient, which averages $1,824 a year--dropped 11% last year. In the last bidding go-around, in 1994, 21 health-care groups, including such national giants as Blue Cross and Cigna, sent in 95 proposals for only 42 contracts. Every county, no matter how thinly populated, offers a choice...
Administrative snafus and tight dollars all around, however, have hurt the quality of care in Tennessee. TennCare critics say the program is often about managing costs, not care. The worse a patient's medical problems, critics claim, the worse the system works. That is, they contend, because the profits for managed-care groups lie in attracting healthy members who require little or no treatment in a given year. "The experience of people with severe disabilities is that they get poor care because, frankly, the provider hopes they will choose another provider," says Carol Westlake, executive director of the Coalition...
This is a lot of chaos for one provincial "control freak" (as Thompson describes her) to manage, and it's only natural that she submerge her interests while dealing with the muddle. Yet, by some patient alchemy, Thompson manages to hold our sympathetic concern despite her self-effacement. Precisely because of her witty, held-back playing, she finally achieves one of those privileged moments we are always hoping to find at the movies and so rarely...