Comments on: The Starling curve and patient volume

By: DB’s Medical Rants » The future of medicine

DB’s Medical Rants » The future of medicine — Mon, 07 Mar 2005 15:39:43 +0000

[...] ere I given the power. In many ways, Saturday I summarized a major concept of this blog – The Starling curve and patient volume. In this rant, I postulated [...]

By: Spinoff55

Spinoff55 — Sat, 05 Mar 2005 17:23:38 +0000

There is an answer… it’s called Consumer-directed healthcare; commoditize the patient-physician relationship to such a degree that the physician is only called upon to pronounce the patient’s death. Call me cynical, but that’s the real destiny for managed healthcare.

By: Tom Wigton

Tom Wigton — Sat, 05 Mar 2005 16:18:23 +0000

Wonderful analogy. I meet with my Chariman this week to address exactly this issue. The pressure to see more patients just does not end, especially in our “academic” practice, (which is busier than any local private practice group). As a high risk obstetrician, I am very concerned that the quality of our care does decrease as our patient volume increases beyond a point. But how to measure outcomes (and of course which outcomes) to answer the question you pose above is very difficult.

By: Abby

Abby — Sat, 05 Mar 2005 15:45:52 +0000

This is (unfortunately) a very good way to look at it. It’s also clearly happening in other areas besides primary care. If you look at the info from the US Renal Data System, the # of ESRD patients has grown, and is projected to continue growing, at a very scary rate. Dialysis is unbelievably regulated, and it’s getting worse and worse. The documentation you have to produce to get paid for dialysis treatments is approaching critical mass-you spend more time writing notes than you do seeing the patients! Makes me glad that I’m based in the hospital. I still have notes to do, but the mass isn’t as great (not like facing 35 chairs full of patients 4 times a day!), and I actually get to talk to my patients! (BTW, I’m an NP in a very large university hospital, working with patients in dialysis and pheresis. Very interesting job!)