Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Thursday, July 31, 2008

Managed Care

Here is everything you need to know about Managed Care in 167 words (yes, they are mine):
Managing medical care consists of deciding what tests are needed to diagnose a particular patient's ailment, and then making sure they get them. Managing medical care involves referring patients to other doctors when a family doctor can't handle the problem alone. Managing medical care means reviewing letters from consultant physicians, noting when they recommend tests or procedures that have already been done or might be dangerous for that particular patient, or when they prescribe medications that either duplicate or conflict with those the patient is already taking. Managing medical care includes preventive care; keeping up to date with the latest recommendations for screening tests for asymptomatic patients, educating patients about the advantages of early detection and treatment afforded by the results of those screening tests, performing them or arranging for them to be performed and explaining the results to the patient. Managing medical care certainly includes encouraging patients to adopt healthy behaviors and habits while avoiding those that are harmful. Managing medical care is called "practicing medicine."
I'm just saying.

5 Comments:

At Fri Aug 01, 12:33:00 AM, Blogger Doc said...

Amen.
Sort of like the bumper sticker: "Gun Control is hitting what you're aiming at."

Can you do what managed care is from the insurers point of view in 167 words? Bonus if you use no profanity. You get to keep whatever words under 167 you don't use, if you're in a capitated system.

 
At Fri Aug 01, 09:56:00 AM, Blogger Blossom said...

Thank you, thank you, thank you.

We've been trying to "manage care" for our two crazy old ladies (aunt & mom) for going on 2 years. We get so danged frustrated at (1) polypharma and (2) doctors that don't read all the background materials that we've carefully provided (both of our COLs are 76, stroke survivors, and have mental/behavioral/cognitive damage). Sometimes we feel like tossing our hands up in the air and saying "well, they've had good lives, why are we wrecking ours worrying so much?" We can't find "managers" for their care in the health-care system; and we've certainly tried to find care-givers that are highly experienced and highly recommended.

Anyway, thank you for so clearly and succinctly saying what managed care SHOULD be.

Enjoying your blog very much,
Blosson

 
At Fri Aug 01, 11:31:00 AM, Anonymous Anonymous said...

Very well said! I would like to add that managing medical care also means respecting the patient's choices and not bullying and/or abandoning someone because of those choices. As you so eloquently said last month, it's not about the doctor's comfort level!

In my humble opinion, the relationship between doctor and patient should be a partnership and not a dictatorship as is too often the case. The doctor should make recommendations which an informed patient processes and then decides which to follow. Unfortunately, I haven't found too many doctors who value an intelligent, informed patient or who look on their "orders" as recommendations!

Keep up the good work. You are doing a great job of getting people to talk to each other and to actually think about these matters.

 
At Sun Aug 03, 07:15:00 PM, Anonymous Anonymous said...

Jiminy! You mean care managed by doctors and not bean counters and the para/non medical personnel/trained monkeys who work for them? WHAT a concept!

 
At Mon Aug 04, 02:36:00 PM, Anonymous Anonymous said...

That which one values gets measured. As a physician, you value seeing your patients sustain their well being-you measure their outcomes associated with "the care" you recommend, adjusting that care accordingly.

Insurance companies primarily measure money-frequently referred to as the Medical Loss Ratio-their preferred outcome, a low MLR.

 

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