"What happens when patients find out how good their doctors really are?"

[akimbo]

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Great article in this week's NEW YORKER by the fabulous Atul Gawande (AKA, "the guy who wrote COMPLICATIONS").

It is about the difference between average doctors and great doctors and what that really means for patient care and experience. Available on-line at:

http://www.newyorker.com/fact/content/

 

[bdt]

Great article in this week's NEW YORKER by the fabulous Atul Gawande (AKA, "the guy who wrote COMPLICATIONS").

It is about the difference between average doctors and great doctors and what that really means for patient care and experience. Available on-line at:

http://www.newyorker.com/fact/content/

Thanks Akimbo! 👍 Appreciate the heads up!

 

[i61164]

Is this page coming up blank for anyone else?

edit: Nevermind. It just took forever to come up.

 

[Febrifuge]

Great article in this week's NEW YORKER by the fabulous Atul Gawande (AKA, "the guy who wrote COMPLICATIONS").

It is about the difference between average doctors and great doctors and what that really means for patient care and experience. Available on-line at:

http://www.newyorker.com/fact/content/

Awesome article. Thanks! (And have I said in the last 10 minutes how much I LOVE being from Minneapolis?) 😉

 

[akimbo]

Awesome article. Thanks! (And have I said in the last 10 minutes how much I LOVE being from Minneapolis?) 😉

I can't say I blame you! Minneapolis - here I come!

I love how the big difference was in Dr. Warwick's aggression in treating the patient on a individual level. Using the same therapies and medicine as the "average" clinic, it seemed to be his individual philosophy (treating the patient instead of just the disease) that made them so much more successful. Really inspiring. I hope I can remember these lessons when I'm practicing.

 

[MeMyselfI]

That was an excellent article!!!!

 

[rockstar2525]

That was a really great article, thanks for posting. I've started thinking about these types of things in the past year, after my friend broke her foot and the EM doc and the radiologist missed the break. She showed me the x-ray, even I could see it! I told the doc I shadow about that, and she said, oh yeah, hosptital x (were my friend went) has really poor care, things like that occur frequently there. I hadn't really thought about that. Like the article said, we are lead to believe that all hospitals are the same and all doctors are equal. It'd good food for thought as we enter medical training!

 

[dopaminophile]

I'm a big fan of Dr. Gawande's. I read "Complications" and loved it. I think he's missing a big part of the issue in this article though. As Michael Ruhlman covers extensively in "Walk on Water," there just simply aren't enough of the best of the best to cover all the patient load in the country. Sadly, some patients are going to go to the bottom of the barrell. My intuition is to say that it's criminal for those on the left of the bell curve to keep on practicing and Gawande alludes to that too. However, at some point as you eliminate people on the left, you're going to be left without enough doctors to treat all the patients. We need to work on improving the mindset of the worst hospitals rather than pulling services from them. The problem is only going to compound as the doctor shortage in certain specialties grows. I would have liked to see Gawande talk more about making bad practicioners better than the difference between average and great. That distinction has already been made many times.

 

[Aero047]

Thanks for the article - loved the book, too 🙂

 

[bdt]

I'm a big fan of Dr. Gawande's. I read "Complications" and loved it. I think he's missing a big part of the issue in this article though. As Michael Ruhlman covers extensively in "Walk on Water," there just simply aren't enough of the best of the best to cover all the patient load in the country. Sadly, some patients are going to go to the bottom of the barrell. My intuition is to say that it's criminal for those on the left of the bell curve to keep on practicing and Gawande alludes to that too. However, at some point as you eliminate people on the left, you're going to be left without enough doctors to treat all the patients. We need to work on improving the mindset of the worst hospitals rather than pulling services from them. The problem is only going to compound as the doctor shortage in certain specialties grows. I would have liked to see Gawande talk more about making bad practicioners better than the difference between average and great. That distinction has already been made many times.

Good point. It makes me fearful that we'll see even more stratification in healthcare. It may become very similar to education in this country. The rich can afford to send their kids to the best schools while poor folks have no choice, but to send them to local public schools (not saying all public schools are bad. I'm a big fan of public schools. Went to one myself). The result is poorer areas have less resources, the rich ones have more and it keeps getting compounded. You may see the same thing with medicine (you already do to a certain extent).

Changes will likely be needed though and I liked a lot of the ideas. M & M meetings help doctors within a hospital learn from mistakes and grow. Institutional M & M might not be a bad idea.

 

[fotolilith]

I would have liked to see Gawande talk more about making bad practicioners better than the difference between average and great. That distinction has already been made many times.

Very good point...tho hopefully there is a movement growing (maybe that inspired this piece?) to retrain bad docs.

Luckily there is a lot of research into how to stop medical errors... making a taxonomy of errors, working with health professionals to improve communication. Good stuff on the horizon.

 

[dopaminophile]

There's a really excellent book called "Internal Bleeding" and I can't remember the names of the authors that looks at how medical errors occur and what we can do about it. It's presented well and very current (Feb 04). Both authors are MDs, so it's not an attack on the profession as you might think. There are good ideas on the state of healthcare and good ideas on how to fix parts of it.