Thursday, October 30, 2008

Health Train Dining Car

image They aren't talking to one another, while they chew their food.

Sometimes a whisper is more powerful than a shout. Here's a cartoon from Modern Medicine that shows a Medical Home counseling session between a primary care physician (PCP), a specialist and the health plan. The PCP looks forlorn, while the specialist and the insurer have their backs turned, fuming. It is perfectly true.

American primary care is a shambles, and it is now clear that it will not be viable in the future unless significant changes occur in our national attitude about its value and in the way we pay for it.

So what should we do?


The National Committee for Quality Assurance proposes a plan

Another interesting, and perhaps more far-reaching proposal (Download finalpcppaper.doc) has been made by Norbert Goldfield MD and his colleagues. Dr. Goldfield is a highly respected health care innovator,

The articles go on to elaborate how this would work, and how PCPs would be rewarded for acting as the fiduciary and patient advocate, unlike the gatekeeper model, which fails miserably.


Collapse, a book which discusses how societies choose to

suceed or collapse is a worthwhile read.


Given the current crisis, and quick fixes proposed by both Presidential candidates it becomes patently obvious the internal mechanisms of patient care  need to be 'fixed'' before any more money is thrown into medical care.  Physicians and educational programs need to climb on board the new Health Train.

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