Blue Mass Group

Reality-based commentary on politics.

Medical care from the ground level

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I already posted today but couldn’t resist sharing this with fellow BMGers.

A few weeks back I put down my thoughts on the ongoing loss of private primary care doctors.  I was extremely pleased by the response.  

Recently a colleague sent me an article from the NY Times magazine set in story form. It outlines choices we may have to make for the direction of our personal care.  It presents the view that a personal physician has a major role in helping people courageously make the decisions they truly want.  Tell me what you think.  Dr. Don Green

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  1. Some of the same messages as those in Atul Gawande’s “Cross Conundrum” article from a year ago, but compellingly  told from the viewpoint of a patient’s family member:

    I believe that my father’s doctors did their best within a compartmentalized and time-pressured medical system. But in the absence of any other guiding hand, there is no doubt that economics helped shape the wider context in which doctors made decisions. Had we been at the Mayo Clinic – where doctors are salaried, medical records are electronically organized and care is coordinated by a single doctor – things might have turned out differently. But Middletown is part of the fee-for-service medical economy. Doctors peddle their wares on a piecework basis; communication among them is haphazard; thinking is often short term; nobody makes money when medical interventions are declined; and nobody is in charge except the marketplace.

    • We now have two stories.  One patient or their family would have preferred the interaction with their personal physician.  The other surmises that this relationship may have happened in a clinic setting.  Both places depend on fee for service even though Mayo doctors are salaried.  

      <

      p>The problem is the displacement of the availability of the private personal physician.  Both should exist according to people’s preferences.  

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      p>It should also be noted if the family in the article had tried to get such care at Mayo’s Arizona office, they do not take Medicare for routine care.

      <

      p>There is not a one size fits all solution.

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