An e-patient call to armsComments on: --

By: amobedragmela

amobedragmela — Wed, 15 Apr 2009 10:10:58 +0000

Теперь я скажу несколько слов о подводке к дичи молодой собаки и о ее стойке.(В работе собаки по дичи следует различать 4 момента (подразделения) ее работы:

1 — поиск, длящийся до того момента, как собака начнет причуивать признаки присутствия дичи в доступном для ее чутья расстоянии;

2 — потяжку — работа собаки, разбирающейся в донесшемся до нее запахе до момента окончательного определения ею наличия дичи; эта работа заканчивается

By: Baby

Baby — Tue, 10 Feb 2009 11:11:27 +0000

There is so new for us! Thanks!

By: e-Patient Dave

e-Patient Dave — Sat, 17 Jan 2009 16:44:27 +0000

Good to see you here, Paul.

If that’s so, then what’s the key?

From my (humble, limited) reading of books and blogs, I have the impression that a lot of organizational behaviors could be explained by asserting that organizations try to postpone costs, pushing them downstream to whoever’s carrying the ball a few years later when a crisis arises.

That’s not directly what Gilles was talking about but let’s explore, if we could.

By: Paul Levy

Paul Levy — Sat, 17 Jan 2009 05:06:28 +0000

There is no indication that hospitals in a single payer environment do a better job with regard to avoiding harm to patients.

By: Gilles Frydman

Gilles Frydman — Sat, 17 Jan 2009 04:07:08 +0000

Do I hear single-payer, universal healthcare system?
This kind of story just wouldn’t exist, in that form, in France, where the hospital budgets are payed by taxes and where plans are made 5 years in advance, because that is what is required to make real changes in the healthcare system.

By: e-Patient Dave

e-Patient Dave — Fri, 16 Jan 2009 12:27:30 +0000

And, btw, I think it’s a little bit pathetic that he got not a single word of response, not even from a single hospital.

Who’ll be the bold one? Who’ll be first to say “That’s a fine idea but it can’t work unless x,y,z.”

And in light of the above, I guess I’m not talking to the hospital staff – I guess I’m talking to the boards. Board members, what do you think?

By: e-Patient Dave

e-Patient Dave — Fri, 16 Jan 2009 12:24:21 +0000

> hospital CEOs — who answer to their > board of directors and shareholders first, patients second Yeah John, exactly. And I don't want to seem intolerant, so I'll ask as gently as I can: if those directors don't have patients as their priority, what is their priority? Beth Israel Deaconess is far from perfect. I've spoken openly about mistakes that were made in my care there (although the oncology team and my surgeon were brilliant). But I also know that Levy frequently says on his blog that change like this requires complete support by the board. Here's an informative post from nine weeks ago: No retreat by the Board, citing a board retreat that ended with "a four-year commitment to eliminate preventable harm and to dramatically improve patient satisfaction." Grand idea. I'd welcome ideas on what we could do to change the priorities of other hospitals' boards, to align with that, so (just as you suggest) the actions of their CEOs align with that goal.

By: John Grohol

John Grohol — Fri, 16 Jan 2009 11:55:45 +0000

I think Paul Levy is being a little naive if he thinks suddenly hospital CEOs — who answer to their board of directors and shareholders first, patients second — are going to set aside decades worth of competition because another CEO asked them to on a blog.

We’ve come a long way, but not so far as to change the fundamental rules of business and competition. While I’m surprised top-level hospital CEOs don’t already meet on a semi-regular basis to discuss general “running a hospital” issues, a *blog* invitation generally isn’t the way to go about setting up such a conversation or discussion (keeping in mind that many (most?) hospital CEOs don’t read blogs to begin with).

If you want a real discussion and conversation about these issues, put a phone call into each CEO’s offices, and setup a meeting. This is still how business is done and Paul Levy knows that.