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View Diary: Brief Notes On The Baucus White Paper About Health Reform (227 comments)

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  •  We have it here. (4+ / 0-)
    Recommended by:
    stitchmd, beltane, Losty, Susan from 29

    Military servicemembers have single payer, universal health care.  It was fantastic, and I miss that access to high quality care on demand...

    No politician ever lost an election by underestimating the intelligence of the American public. PT Barnum, paraphrased...

    by jarhead5536 on Wed Nov 12, 2008 at 03:03:45 PM PST

    [ Parent ]

    •  I am on Medicare and consider it an very well run (0+ / 0-)

      program. It would benefit enormously by electronic record keeping which i have read would save billions.

      •  Electronic Medical Records are a NIGHTMARE (0+ / 0-)

        at least the system that our office has implemented are. The upfront costs are huge, the inefficiencies have been unbelievable, the stress it's placed on the office is tremendous.

        Sounds good in theory, but like many things, in practice it can be something else.

        Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - WSCoffin

        by stitchmd on Wed Nov 12, 2008 at 03:36:53 PM PST

        [ Parent ]

        •  OK so what's the solution to cutting down (0+ / 0-)

          administrative costs?  My dermatologist office says it has helped them enormously, so I don't know.  

          •  I've had lots of conversations about this (0+ / 0-)

            for specialists, it can be helpful for the majority of patients. Specialists typically deal with a more restricted type of case mix, so having a quick "click it" menu can work for those patients who fall under specified diagnoses.

            I've even talked to the pediatricians who use the system we do. About 50% of pediatric care is well-child care, so it's fairly cookbook - graph weight and height here, order immunizations there, print up some parent educational materials. About 50% or more of the rest is also fairly cookbook - ear aches, sore throats, GI disturbances. This is the kind of thing that's well accomodated by EMRs.

            And I'll say that after I saw two young, healthy patients for physicals yesterday, and went down the "checklist," it was perhaps somewhat quicker.

            What computers don't do well is deal with complexity, and when you're talking about a geriatric internal medicine patient with multiple medical problems, where you are trying to get a sense of how all those problems integrate, believe me, computers are far, far more of a hindrance than a help. Add to that that our office is participating in a Medicare pilot project to get "data," and you wind up spending more time trying to collect that data from the records than you do actually working with the patient, and it's an impediment to true patient care.

            Look, I'm not computer illiterate. The fact that I'm here should speak at least in part to that. But we've been doing this for 9 months now, and I'm finding more and more limitations, not fewer. I spend more time on "how" I'm doing than on "what" I'm doing. I haven't seen it help to reduce errors. It adds time to simple orders.

            I could go on and on and on.

            Costs, however, were much lower when docs weren't always being second guessed, but that was well before my time.

            Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - WSCoffin

            by stitchmd on Wed Nov 12, 2008 at 04:41:32 PM PST

            [ Parent ]

        •  they work very well for the VA, apparently NT (1+ / 0-)
          Recommended by:
          stitchmd
        •  I worked in the VA system for 2 years (0+ / 0-)

          They can show you how to take a good electronic system and make it the worst

          American dream is a myth!

          by brown american on Wed Nov 12, 2008 at 06:58:31 PM PST

          [ Parent ]

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