Wednesday, October 6, 2010

Former Obama budget chief says doctors must work weekends, be 'managed' by system, says 'inevitable', industry can no longer 'protect' them

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Peter Orszag says doctors should "consent to management," it's "inevitable" he says. MD's gave time and money to qualify for an entirely different job in a different country. No reason to hang around for this.
"Peter Orszag, former Obama economist, is suggesting that doctors need to start working evening and weekends. Here’s a taste:

"Doctors, like most people, don’t love to work weekends, and they probably don’t enjoy being evaluated against their peers. But their

Imagine a drugstore open only five days a week, or a television network that didn’t measure its ratings. Improving the quality of health care and reducing its cost will require that doctors make many changes —

  • but working weekends and
  • consenting to quality management are two clear ones.

That’s why an effort at New York University Langone Medical Center to institute both of these changes is so important. If it succeeds, it will help point the way to the

  • health care system of the future.

First, weekends. It’s never good to be hospitalized, but you really don’t want to be hospitalized on a weekend. There are fewer doctors around, and people admitted on Saturdays and Sundays fare relatively poorly.

One study in 2007 found, for example, that for every 1,000 patients suffering heart attacks who were admitted to a hospital on a weekend, there were 9 to 10 more deaths than in a comparable group of patients admitted on a weekday. The weekend patients were less likely to quickly receive the invasive procedures they needed — like coronary artery bypass grafts or cardiac catheterization.

It’s not just a safety issue but, for less life-threatening medical problems,

  • also a matter of convenience.
  • Wouldn’t it be nice to be able to schedule your elective surgery on a Saturday if you wanted? Most hospitals don’t offer that option.

And then there are the economics of a $750 billion-a-year industry

  • letting its capacity sit idle a quarter or more of the time.

If hospitals were in constant use, costs would fall as expensive assets like operating rooms and imaging equipment were used more fully. And if the workflow at existing hospitals was

  • spread more evenly over the entire week, patients could more often enjoy the privacy of single-bed rooms."...

(American Blogger): When I read this, I thought, “I’ve read this somewhere before.”

"GPs will be asked to work in the evening and at weekends after the Government indicated that it is to reopen the contentious issue of out-of-hours care by family doctors, The Times has learnt.

Alan Johnson, the Health Secretary, will tell doctors this week that it is ludicrous that surgeries shut their doors as people leave work and that GPs, whose average salary now tops £100,000,

  • must become more flexible and “customer oriented”.

He will ask Sir Ara Darzi, professor of surgery at Imperial College, London, who was appointed a health minister by Gordon Brown in July, to find a solution as part of his review

(continuing American Blogger): So how exactly has that worked out in Great Britain?

Exactly like you’d think:

"The huge extent to which the NHS needs foreign doctors to treat patients out of hours is revealed today.

A third of primary care trusts are flying in GPs from as far away as Lithuania, Poland, Germany, Hungary, Italy and Switzerland because of a shortage of doctors in Britain willing to work in the evenings and at weekends.

The stand-ins earn up to £100 [$162] an hour, and one trust paid Polish and German doctors a total of £267,000 [$434,674] in a year, a Daily Mail investigation has found.

It raises fresh concerns that British patients are being treated by exhausted doctors without a perfect command of English.""


.via Gateway Pundit

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