Health care policy

I am a regular doctor.  My job is to take care of people.

I see, ablate, and operate on patients every day.

I work in the real world, outside of an academic institution or think tank.  Sadly, I do not have a foundation.

Like most doctors, I take pride in my work.   No quality assurance person is harder on me than myself.  I hang a lot of my self-worth on my skills as a doctor.

But I have my own kryptonite: farcical things that in the name of quality improvements, or controlling costs, or enhancing equity actually impair patient care.  Here are a few examples:

  • Protocols for everything.
  • Mindlessly thinking that guidelines apply to all patients and that spreadsheets or checklists can measure quality.
  • That it takes longer to do the paperwork for a procedure than the procedure itself.
  • That my note to a referring doctor, which should be a chance to tell an interesting story, has devolved to an invoice that proves I am not over-charging someone.
  • That much of healthcare policy emanates from think tanks, academics and politicians rather than real-world doctors.   (I realize that this is partly my fault.)

In writing on doctoring, healthcare policy issues come up frequently.  When they do, I label them Health Care, or Health Care Reform. A few months ago, I dreamed that I was the surgeon general, and had a plan to solve our obesity crises.

When I discover something new that is worthy of noting, I label it Knowledge.  Or if I am simply yammering on something of my choice, I label it Reflection.