Favorite Quotes
"For every complex problem, there is a solution that is simple, neat, and wrong." - HL Mencken
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"I hear and I forget. I see and I remember. I do and I understand." - Confucius
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"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler
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" The best test of a person's character is how he or she treats those with less power." - Bob Sutton
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"Those are my principles, and if you don't like them - well, I have others." - Groucho Marx
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"The difference between genius and stupidity is that genius has its limits." - Albert Einstein
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"It is hard enough to remember my opinions, without also remembering my reasons for them" - Friedrich Nietzsche
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"Anyone can make the simple complicated. Creativity is making the complicated simple." - Charles Mingus
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"Not everything that can be counted counts, and not everything that counts can be counted." - Albert Einstein
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"A foolish consistency is the hobgoblin of little minds, adored by little statesman and philosophers and divines. With consistency a great soul has simply nothing to do." - Ralph Waldo Emerson
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"This ain't no party, this ain't no disco, this ain't no fooling around." - Talking Heads, Life During Wartime
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"What is hateful to you, do not do to your neighbour. This is the whole Torah; all the rest is commentary. Go and learn it." - Hillel, Talmud, Shabbath 31a
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"You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing." - Thomas Sowell
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"An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup." - HL Mencken
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"If you only have a hammer, you tend to see every problem as a nail." - Abraham Maslow
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"A great teacher is one who realizes that he himself is also a student and whose goal is not to dictate the answers, but to stimulate his students creativity enough so that they go out and find the answers themselves." - Herbie Hancock
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"There are no facts, only interpretations." - Nietzsche
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"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't." - Anatole France
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"In character, in manner, in style, in all things, the supreme excellence is simplicity." - Henry Wadsworth Longfellow ====
Nov - 15
Dec - 19
Jan - 21
Feb - 8
Mar -
Thinking inside the box will not work – we need a new box
5 Oct2009
Evan Falchuk has an important post today. He rightly points out that the current debate focuses on the wrong issues.
Your care may be paid for by a private insurer or a public one. Your coverage may be called a “Cadillac” plan or a high deductible plan. You may be uninsured. But there are some things that will be virtually certain if you get sick regardless of who and pays for your care and how:
The majority of your medical visits are going to feature face-to-face contact with your doctor of 15 minutes or less. Your care is going to be fragmented, with information about you stored in paper files, electronic records, and the memories of the doctors you have seen. You’re going to be on your own, facing important decisions, with too few places to turn to for help.
It’s bad, and in my experience, almost everyone I talk to on this subject has some personal experience with health care that looks just like this.
We do not have a health care system. What works for the convenience of subspecialists does not work for patients or primary care physicians. We need some new thinking.
In this blog I have recently advocated having primary care leave the current insurance paradigm. My reasons focus on the high overhead dealing with insurance companies, the irrational documentation requirements and the payment challenges.
Evan has it right, true health care reform is not just about money, but rather the entire structure of providing health care. It is about patients, not about physicians. Of course the radical right and left both miss the point and the middle does also. Few pundits understand the problem, thus the solution will remain obscured.
We need to spend enough time with each patient. We must eschew any system that discourages us from spending time with patients.
Of course, I am most worried about patient care, not budgets. I believe that attending to patient care in a proper fashion will decrease costs.
Related posts:
- Pulling primary care out of insurance
- Thinking is undervalued
- False positives – from 6 years ago
- Listen to the stories
- Improved performance – P4P or consistent primary care?
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- In: Medical Rants
4 Responses to Thinking inside the box will not work – we need a new box
Thinking instead the box will not work – we need a new box - Health Articles A to Z
October 5th, 2009 at 4:06 pm
[...] View post: Thinking instead the box will not work – you need the brand brand new box [...]
Don’t Get Sick « See First Blog
October 5th, 2009 at 5:20 pm
[...] UPDATE: Dr. Bob Centor, who does some of the best blogging on this kind of ‘re-thinking’ of health care has a post up on this point that’s well worth reading. [...]
brian
October 6th, 2009 at 4:43 pm
Bravo Db. spot on once again….
if only the politicians would read your blog
seriously, I have real worries that the AMA does not represent the majority of physicians and doctors are not on capitol hill voicing ANY opinion about the reform.
Doctors!! we are supposed to be the healthcare leaders of this country and we are sitting on our butts while the Insurance companies are in the senator’s offices convincing them that THEY are the real healthcare leaders of the country.
how could we have let that happen???
Paul Roemer
October 12th, 2009 at 3:54 pm
Agreed. Once everyone thinks they are thinking outside the box, aren’t they all by definition back in the box? I try to get my clients to color outside the lines. I find that works better especially since most people fear drawing.