Vision for the Future of Medicine

08/21/2005 21:39:51
tags: medicine

MedicalThoughts

Prologue

This page (or pages) is definitely a work in progress. I will slowly try and flesh out some ideas that are currently mere “idea-lets” in my mind. I welcome contributions from others - I’m not sure where this idea may go, but perhaps some good may come of it!

Note: I am struggling with the voice for this series of pages. It represents my thoughts and opinions on various aspects of our healthcare system, and, especially in its infancy, seems to belong in the first person. However, I want to encourage input from others as well, which is somewhat incompatible with the first person. So I’m just going to get started, and see where it goes. I can always fix it later! [I am definitely open to ideas on this]

Also, please feel free to use the comments pages for discussion. Feel free to make changes to the main pages, but if you want to discuss something, do it on the comments pages. This way, the discussions can preserved, while maintaining the main pages as a readable “final” copy.

Purpose

I hope that this document will come to represent a somewhat organized, if incomplete, expression of my thoughts about the future of healthcare. As a physician (currently in a residency in Internal Medicine), I certainly have some strong opinions about certain aspects of our healthcare system. But one doesn’t have to work in the medical field to impacted by it in various ways on a daily basis.

I hope to point out problems with our current system, and where at all possible, provide suggestions for improvements. Some of these suggestions will relate to the business models of medicine, some towards technology, and some towards our ideas of social responsibility and rights.

This is more of a discussion than an “answer.” I don’t have the answers, nor do I pretend to. But I hope to be able to prompt discussion that might lead to some useful ideas. At the very least I hope to be able to organize my thoughts more clearly. But what I truly hope is that others who are interested might become involved in the creation of this document, either by describing opposing ideas or arguments, adding new content, or simply suggesting improvements that make the document more readable.

Organization

[Not sure yet]

What Healthcare Could Be

This section will offer a description of what I think healthcare has the potential to become. To make it more easily understood, and “real”, I will provide this in narrative form, rather than as a verbose academic thesis… The trick is for better writers than myself to help improve the story once it is fleshed out.

Ideas to incorporate:

  • able to devote full attention to pt for appropriate period of time - not an assembly line

  • ready access to all pertinent info for both pt and practitioner

  • optimize health and prevention, not just fix problems after they occur

  • able to address social barriers to compliance with therapy (cost of prescriptions, referrals, etc)

  • put more control in hands of patient - shift some of the responsibility to them (how long of an appointment do you need?, do you have paperwork that needs to be filled out?, do you need medications refilled?, etc)

  • give pt access to their information for home - health maintenance should be a continuous process, not something that occurs in 15 minute intervals separated by months of neglect…

  • Ways to integrate technology to reduce time spent in technical activities, and increase time spent face to face with patient (evidence based medical decision making, automated chart review, prescription refills, lab review, summarize past records, allow pt to review their own records from home, etc)

Predictions

I don’t claim to be an expert on the future of healthcare in this country, or any other country for that matter. So these aren’t really predictions so much as hopes, based on nothing more scientific than my own experiences and dreams.

To be expanded:

  • things will get worse before they get better

  • I truly believe they will get better

  • changes will come from several directions: practitioners, patients, insurers, government, non-profit groups, and perhaps even more clear-thinking members of the legal profession

  • technology will play a crucial role in improving access to services, streamlining the more “clerical” aspects of healthcare, detecting areas for improving quality of care by picking up on small trends that humans can’t detect (or don’t have the time to look for)

Assumptions

Unconsciously, our assumptions limit the solutions we are willing to entertain. In an effort to combat this, here is a list of some of the assumptions that exist about medical practices. By naming them, perhaps a new way of doing things might evolve…

(Note: this is very stream-of-consciousness…)

  • It must be “professional”, whatever that means

  • conservative

  • traditional power relationships - doctor has power, patient does not

  • scheduling hassles - doctors and patients running late

  • can never get an appointment when you need it

  • expensive

  • stiff, formal, sterile, uncomfortable, uninviting

  • not fun

  • scary

  • waste of time

  • inefficient

  • something that can be put off until later

Related Topics

  • ElectronicMedicalRecords

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