You took wrong Mark. I'm a veteran and I know the VA system. Am I to
guess you're somehow affiliated with the VA and took exception?
I didn't say one couldn't get good care at a VA. I said, given a
choice I'd prefer a non-gov't run hospital, except depending on
diagnosis. Lots of people seek out care for testicular cancer at
Indiana University (Lance Armstrong is a famous one), but they don't
go there because its IU. They go to IU because thats where they find
Larry Einhorn.
The points you mentioned below all relate to efficiency. I answered
Tom's question based on my perception of quality of care. A state-run
med school affiliated hospital or practice would not be my first
choice for routine care. Students need practice and learning
opportunities, but I'm under no obligation to provide it personally.
Its not relevant that any given VA facility, or the VA on whole while
may or may not be the "best run hospital system in the country." That
the residents managing pt care are supported with barcoded systems,
EMRs, and an efficiently purchased formulary is also not relevant to
my care decisions. I don't want a resident front-lining my care
(especially at the beginning of the year) no matter how efficient the
system is said to be.
Interestingly, all that "most advanced medical software" is a current
topic of discussion in the churning swirl of medical education. A
growing percentage of students is being found unable to compose a
patient summary without using the system. Is medical education
training techs to follow drop-down lists and history forms? Granted,
care directed using a validated system strictly followed will
probably reduce malpractice risk. It will also help make appt's
quicker so more pts can be seen in a day to help make up for lower
reimbursements. But, the argument goes, is that what we want from a
physician? I seem to think more and more we do, at least until we
get what we're asking for. I just hope the developers have the
newest CASE tools and use some of that artificial intelligence and
fuzzy logic to build the systems.
cb
On Sep 30, 2007, at 10:57 AM, Mark Corrigan wrote:
On Sep 26, 2007, at 11:14 AM, Charles Ballinger wrote:
Any except the gov't hospital.
What government hospital are you talking about? I take it that you
are not a veteran and no nothing about the VA. The VA is the
biggest hospital system in the world and provides very good care
for the less money than any other hospital in the US. The VA is
not constrained by the latest medicaid/medicare bill that prevents
bulk bidding for medicines. As a consequence the VA pays the least
amount for medicine of any hospital in the US. The VA is the most
computerized and has the most advanced medical software of any
hospital in the world. The VA was using bar code scanners to scan
patients and pass meds 10 years ago. This makes it virtually
impossible to have a medication error. Doctors do not hand write
orders at the VA. All orders have do be entered into a computer.
Hand written orders are the number one reason for medication
mistakes . They kill some where in the neighborhood of 100,000
people per year in the us. All hospital in this country have
problems (including the VA), but please don't knock the best run
hospital system in the country (which happens to be government run)
to private hospitals. By the way the VA is not Walter Reed which is
a army hospital for active duty soldiers. And one of Walter Reed's
biggest problem's came about because they privatized their
janitorial staff with a subsidiary of Haliburton.
For profit and nonprofit are equal except if you're a high risk OB/
sick mother case and would prefer the mother be saved by
sacrificing the baby should it come to that. In that case you'd
want to avoid certain religious affiliated hospitals.
On Sep 26, 2007, at 11:05 AM, Tom Piwowar wrote:
Given the choice of three hospitals and knowing only that one was
run by
a government agency, one was run by a for-profit corporation, and
one was
run by a religious-charitable organization, which would your choose?
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