Posted on 07/31/2010 4:00:59 PM PDT by Big Bureaucracy
You’ve heard the phrase “We should pay the health care providers not for “volume of care” but for “quality of care”. You’ve heard it from politicians on the left, right and center. You’ve heard about the transition to “evidence based” care that will save us tons of money. But do you really know what “quality of care” means and what “evidence based medicine” means.
Quality means different thing to different people. Quality may refer to the perception of the degree to which the product or service meets the customer’s expectations. Your grandma’s apple pie may be the standard for quality for you. However for a Continuing Improvement Specialist quality is lowering the standard deviation in outcomes. The McDonald’s apple turnover is closer to quality for such scientist – it tastes the same in NYC, California and Arizona.
So when President Obama promises you quality health care you think you will get care that meets your expectations, however the ObamaCare means quality in more ‘scientific’ terms as: everybody will get about the same care. How much care you get is not designed according to you and your doctor’s expectations, but according to the government expectations of less deviation in outcomes.
Let’s look at the science in the heart of the ObamaCare new bureaucracies and scientific projects – the Accountable Care Organizations that will measure “quality of care” and reimburse providers accordingly.
The main ideology is best described with Milton Roemer’s phrase: “A built hospital bed is a filled hospital bed.” The idea is that if you go to health care provider with lots of capacity (beds, physicians, and equipment) the provider will utilize all available recourses. More care however does not translate into better quality care.
(Excerpt) Read more at bigbureaucracy.com ...
We already have the best health care in the world. What we will get with commie care is CRAP!!!!!
IMPEACH THE SONS OF BITCHES!!!!!!!! And zero called himself a mongrel-—so it
follows HE’S A SON OF A BITCH.
The Obama regime and the Rhino sycophants couldn’t care less about the health of individual citizens. It’s all about providing every working age piece of state property with enough health to be productive in building the socialist utopia. The less useful ‘untermenschen’ are on their own to seek private care even while being taxed excessively.
Socialists always use catchy words but behind those campaign promises is more misery.
My experience with doctors that preach “evidence based medicine” is that “evidence” is what they consider “evidence”, namely test results, plus clinical signs, which are responses from patients that can be seen or felt or measured by the doctor. Notably absent as “evidence” for such docs are clinical symptoms, namely that which a patient describes orally, such as, “Doc, I wake up screaming from pain at night.” Nothing the patient says is meaningful to an “evidence” based doctor.
In point of fact, such doctors simply approach medicine as if they were a veterinary for humans, treating the patient is incapable of providing any useful information. On more than one occasion, I’ve actually had such a doctor try to get me to cease effective therapy so that they could “see with their own eyes” the original signs and look at the results of new tests after the therapy ceased, because otherwise they had no “evidence” that I had actually been ill without the therapy!
Should a doctor describe themself as “evidence based”, you should run screaming from the exam room. OK, actually, you should just politely put your clothes back on and leave. Hopefully, you’ve established whether a doc is “evidence based” prior to the doc actually spending any time with you, at which point you should request that no bill be prepared, whether it is an insurance bill or not.
That is exactly the point. Evidence based care treats the patients like statistics not like individuals.
Do you really want quality health care?
No, I want pretty good health care at a pretty good price.
I want the government out of my healthcare.
I think that does not properly describe it."Already" may imply that it will keep getting better. The reality is that we have embarked on Kenyan socialist medicine. Health care and with it the people's health will get worse. "Already" might better be replaced with "still" - "We still have the best health care in the world."
All the fantastic advances one can read about weekly if not daily must come to nought. Research will peter out and die and all the new wonders that would take 5 to 10 years or more to get to market will never get there and those that get to the hospitals and doctors' offices will be mostly left on the shelf because, as new procedures they will be expensive to use and our doctors will not be permitted to use them. Advance is over. We have applied the brakes and the transmission is shifting into reverse. One can only hope that the speed in reverse is very slow.
“I want the government out of my healthcare.”
Amen. In this way, and in this way only will healthcare become affordable to everyone.
The money line:
“...for a Continuing Improvement Specialist quality is lowering the standard deviation in outcomes. The McDonald’s apple turnover is closer to quality for such scientist – it tastes the same in NYC, California and Arizona.
So when President Obama promises you quality health care you think you will get care that meets your expectations, however the ObamaCare means quality in more ‘scientific’ terms as: everybody will get about the same care. How much care you get is not designed according to you and your doctor’s expectations, but according to the government expectations of less deviation in outcomes.”
Exactly - they promise quality health care, quality education, quality anything - it is not what people expect. It is about making everything average (mediocre).
Nursing is now stressing “evidence based” practice as well. Ok so maybe it might be nice to have research to support all of the things we have been doing for years, or to prove that they may not be as therapeutic as we once thought. But the real impact on the bedside nurse is we have reams of paper with check boxes to score and to add up to a total which will tell us how to care for the patient. HUH?!?
For instance in our facility we have a 5 page care plan just for skin integrity. 5 pages! Everyday! For all of your patients! In the amount of time spent on the damn thing I could be actually doing what the damn thing says should be done. Personally I consider the thing an insult to my intelligence. I was taught how to do care for at risk patients 20 years ago in CNA school. It has never failed me.
Then on top of that the facility is spent a ton of money trying to retrain everyone so new grads will have “instinct”. But to me “nursing instinct” is the opposite of “evidence based practice” as it is subjective in nature.
Real quality in healthcare is achieved when well trained practitioners get to apply their skills to their patients with plenty of time and support as they learned to do through their education and experience - but this gives the providers too much power and autonomy which politicians - especially those who crave control over as much of the public life as possible - resent - so they introduce terms like "outcome determined care" to try to get their foot in the door of the medical system - a door they weren't smart enough to get through by going to medical school to begin with.......
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