We need to be more efficient with delivery of medical care

2seaoat wrote:My first observation is that most medical facilities I have had the good fortune to visit in the last five years are clearly above average. However, I have the privilege of seeking treatment at one of the nation's best research medical facilities at Northwestern University hospital in downtown Chicago.

However, I will explain what happen on Monday when I received my monthly shots. My appointment was at 8:15. I arrived at 8:15 and they have a desk with two receptionist who get your name, birthdate, and then check what procedures you are scheduled for that morning and either give you a number, or a restaurant vibrating disc which vibrates and lights up when they are ready for you. There are four doors for treatment in a large waiting room on the 21st floor. Door 1 is for doctor appointments and leads to doctor offices. Door 2 is lab work and blood draws. Door 3 is more doctor appointments, and Door 4 is infusions of chemo and various injections dealing with cancer treatment.

At 10:15 on Monday my number had not been called for two hours....I politely went to the reception desk and asked if there was a problem. They answered they were behind, and I would be called in 15 minutes. At 11:15 I was called into the infusion door, and proceeded to get my shots in about 15 minutes. Patients are then required to go to a patient services desk and schedule their next shot....and get insurance approval. I went to the desk for scheduling, and my usual contact was out to lunch and nobody could schedule my special shots.....so I waited 45 minutes. She got back and set my up for my January and February shots, but the Doctor had ordered a cat scan to measure growth of the tumors for February. I asked if I could schedule that test.....nope, and I was sent to another window. I waited 20 minutes to talk to somebody, and then there was confusion as to what areas my scans would cover.....and the lady did not want to schedule the scan until I told what things would be scanned......I Politely suggested that I am not a doctor, and I would suggest she schedule what the doctor ordered......another 20 minute delay as we tried to get the cat scan later the same day as my February shot......mission accomplished and about 1:30 pm I left the hospital after spending 5 1/2 hours to get shots and schedule my next procedures.

I am going to a great many hospitals, and the newest fade is this great scheduling system where when you get off the elevators they have large screen tvs with the first initial of the patient and last name, doctor, the area or door you are supposed to report, and the best part a status as to time of your appointment every 15 minutes......consistently they are within 15 minutes of their scheduled appointment. They have a couple people to make this great system work.....at Northwestern we are talking about 15 employees at reception and various scheduling ports.......The sad thing is that I am really still doing pretty good, but I see people who are weak and dying, and family members getting very angry.....which sadly does not help at all......so I have written a very constructive letter suggesting utilization of scheduling software, big screen tvs, numbered doors and flashing numbers above each door when a persons appointment time has been reached......I will see if they will enter into a dialogue, but I figure while I am still strong....someone has to show them that for very little capital, there are real world solutions which can save money, help people who are gravely ill, and create an environment where people do not have to be rude......I will see what I can accomplish, but the biggest challenge we face in health care is efficiency and cost reductions.......it does not matter if it was the Affordable Care Act, or Medicare for all......the problems must be addressed and fixed.

2seaoat wrote:There are multi billion dollar businesses including Mr. Studer's who implement productivity improvements in the hospital environment......but without context and standards....we have the current chaos. Rather, than starting to build a house from the roof down to the foundation......I think we need to build the house starting with the foundation. The government has been focusing on how we pay the bills in my opinion, and not enough time on lowering the bills with efficient system wide standards. I do not hide my beliefs that medicare for all will be the start to designing efficient and cost effective medical delivery systems........and certainly medicare for all could finally start to address clear standards across the board which save folks money......but as a fiscal conservative who wants efficiency in government with the fewest bucks spent....I am transformed into a socialist when talking into medicare for all.

I had the privilege of meeting Bob Dole. A republican who I have the greatest respect. This man could not be elected dog catcher in today's dixiecrat party which has stolen the Republican brand. Special interests have bought and paid my party, and I think anything is going to improve in medical services and standards?

http://articles.baltimoresun.com/2012-12-05/news/bs-ed-compassion-gop-20121205_1_disabled-people-treaty-human-rights

2seaoat wrote:Your a socialist . Period.

If being a socialist is defined as having a more efficient delivery of medical services at lower costs......well, I guess there are a few folks who think like that......but.......If standardizing rails and the government giving large grants of land to develop rail systems throughout America was socialism.....well at least it was corporate socialism.....then I will take whatever label you want to hang on me.

Please do not tell me about medical records being worked on and standardized.....I call BS......it is a nightmare, and I guarantee you that they will not implement jack to make sick people's lives better in the next year....it is chaos.....but if you work in the medical field.....you want to rationalize that 25 years after the technology was in place to have standardized digital records......nothing has been accomplished......it must be all those damn socialists which are creating the problems.

Oh......and I heard the UN is sneaking into people's homes and stealing first borns.........

2seaoat wrote:What happened to the doctor coming to your house?


The AMA and the medical monopoly. Limiting the supply of doctors retains profits for the few. Double medical school enrollments, and you will start seeing house visits becoming common again. Physician Assistants are doing wonderful things in some states, but are limited by the monopoly in other states. Expand the scope of what PAs can do, and folks will start coming first instead of an inefficient broken down medical monopoly which excercises power to maintain the status quo.

2seaoat wrote:How would you double medical school enrollments? Lower the entry standards down to that of a ninth grader?

HMMMMMMMM .......how would I double medical school enrollment.....I would have the federal government set up a 100% loan guarantee for medical school students with foregiveness of the loans for each year of general practice in an underserved community as determined by census. I had the pleasure of living in Mexico in the 1975 when students who were top 5% of their college classes with great MCAPs were going to medical school in Mexico because there were not enough seats in America to train those doctors......I have seen too many absolutely incompetent doctors to last a lifetime, and the difference between a 3.89 grade point average and a 3.60 point grade point average may represent the difference between an extremely bright and well adjusted college grad and a ninth grader to you........but the monopoly will come tumbling down....people will come first.....and God forbid that a physician would only make 150k a year, and PA could prescribe antibiotics with physician supervision.

2seaoat wrote:Let me ask you, would it be ok to limit how much a bussiness owner makes to $150,000 a year?

Yep.....if the antitrust provisions of our current laws went after a monopoly where a few businesses had policies which thwarted competition illegally, and the government stopped that practice......and instead of those business people who were profiting from an illegal monopoly making 350k....they now were making 150k because of competition and lower costs of goods or service......well that called the American capitalist system.....and it works.

Trusts and monopolies which corner a market are anti capitalist......and free markets and competition is the bedrock of our American free market system.....comrade chrissy......are you coming over to our side....even without your indoctrination.....and even without your card? Every good communist wants to defeat free markets with monopolies.......very good comrade.....we will have you soon as a full fledged communist who thwarts the free market system.........but I still think you have to wait for your card.

2seaoat wrote:How would you double medical school enrollments? Lower the entry standards down to that of a ninth grader?

HMMMMMMMM .......how would I double medical school enrollment.....I would have the federal government set up a 100% loan guarantee for medical school students with foregiveness of the loans for each year of general practice in an underserved community as determined by census. I had the pleasure of living in Mexico in the 1975 when students who were top 5% of their college classes with great MCAPs were going to medical school in Mexico because there were not enough seats in America to train those doctors......I have seen too many absolutely incompetent doctors to last a lifetime, and the difference between a 3.89 grade point average and a 3.60 point grade point average may represent the difference between an extremely bright and well adjusted college grad and a ninth grader to you........but the monopoly will come tumbling down....people will come first.....and God forbid that a physician would only make 150k a year, and PA could prescribe antibiotics with physician supervision.

Jake92 wrote:My 90 yr old father recently had a follow-up appointment with one of the drs in one of the specialty clinics at Sacred Heart. The nursing assistant was pushing to get the paperwork finished before bringing the dr in to see him. It's the same info the hospital has, ie; meds, medical history, insurance, etc.. I told her that the hospital has all of the info and he was just released 5 days earlier after being an inpatient for 4 days. She said "I need it because the hospital computer system is different than the one we use". A few minutes later, the PA came in, NOT the dr he was scheduled to see. The PA had all of the info from the hospital on her laptop. After working in the medical field for 40 years, the problem I see is incompetence of the assistants, (technicians, nursing assistants, administrators). Everything is run for profits and to document things to prevent lawsuits by GREEDY lawyers and patients..

Another patient (my wife) had hip replacement surgery. After complaining of pain for a few hours, the dr doubled the dose of pain meds. After 8 hours, the machine that dispenses the pain meds said "bag empty". An hr later, a nurse came to change the bag and the original bag was still full, but upside down in the machine, so the patient never got any pain meds. After removing the old full bag and putting the NEW bag in the right way, she overdosed on the pain meds because the nurse never contacted the dr about the bag being upside down.. A few days after she was released, we got a phone call from a lawyer offering to take the case to sue the hospital, dr, and nurse. We told him NOOOOOO, it was just a simple mistake.. We got mail and phone calls for the next few weeks from different law firms offering to take the case and trying to talk us into suing because the case would be an open and shut case and she would win. We did NOT sue..