Posted on 11/21/2010 11:46:30 AM PST by wagglebee
First they did away with house calls, now Donald Berwick wants to dramatically restrict office calls. Or at least, that’s what the temporary (recess appointment) Medicare chief and rationing proponent advocated in a document he wrote and published before entering government while the head of the Institute for Health Care Improvement.
In Escape Fire: Lessons for the Future of Health Care, Berwick makes a breathtaking proposal that would seem to guarantee each of us all the health care we want, whenever we want to receive it . From page 42:
The new system of access can be summarized in one phrase: “24/7/365.” The access to help that we will envision is uncompromising, meeting whatever need exists, whenever and wherever it exists, in whatever form requested.
Whoa. That certainly doesn’t sound like the Donald Bewick who has waxed romantically about the rationing board NICE and the UK’s NHS.
So, how do we square the two Donald Berwicks? There’s a catch! Berwick simply restricts the scope and meaning of “whatever need exists, whenever and wherever it exists, in whatever form requested” so that, as implemented, it would eliminate most face-to-face patient/doctor interactions. Again, from page 42:
Access 24/7/365 begins to be achievable only when we agree—scientists, professionals, patients,payers, and the health care workforce—that the product we choose to make is not visits. Our product is healing relationships, and these can be fashioned in many new and wonderful forms if we suspend the old ways of making sense of care.
The access we need to create is access to help and healing, and that does not always mean—in fact, I think it rarely means—reliance on face-to-face meetings between patients, doctors, and nurses. Tackled well, I believe that this new framework will gradually reveal that half or more of our encounters—maybe as many as 80 percent of them—are neither wanted by patients nor deeply believed in by professionals…
The health care encounter as a face-to-face visit is a dinosaur. More exactly, it is a form of relationship of immense and irreplaceable value to a few of the people we seek to help, and these few have their access severely curtailed by the use of visits to meet the needs of many, whose needs could be better met through other kinds of encounters.
Dinosaur? “Healing relationships?” (Gobbledygook alert!) 80%!
Sure some efficiencies can be realized by having doctors available by phone, using e-mail, and having test results sent by computer. This is already done in some plans, such as my mother’s Kaiser Permanente Medicare program. But chat rooms, “group visits of patients” (what about privacy?), and other hands off methods, can only do so much and go so far. Moreover, doctors use face-to-face meetings for more than just exams. Sometimes, a doctor can take one look at a long-time patient who might be unwell and tell that something is amiss. In short, doctors need to see patients.
Berwick is thought of by some as a visionary. He is certainly dedicated to bringing new ideas to the practice of medicine. But it seems to me that when he wrote that we all should have total access whenever and however we want it, he wasn’t being straight. He was really talking about another method of restricting care. Moreover, it is one thing for younger and healthier patients to use more modern methods of communication. It is another for the elderly and the relatively uneducated. We aren’t all into I-phones.
That is why I fully expect–and want–his formal appointment as Medicare head to be rejected by the U.S. Senate. Let him go back to the non profit sector where he can bubble over with ideas and promote futuristic medical procedures and processes–outside of the corridors of real power.
Confirmation of Berwick would mean immediate health care rationing for seniors.
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This country is going down the toilet at an exponential rate.
Time to start the 24/7 nonstop calls to DC while we’re still left with enough freedom to use our telephones.
“,...I believe that this new framework will gradually reveal that half or more of our encounters—maybe as many as 80 percent of them—are neither wanted by patients nor deeply believed in by professionals ...”
Here is another man who, like most other leftist ideologues, justifies his grandiose schemes by making up his own convenient reality as he goes along.
The first time a doctor makes the wrong diagnosis because they tried to treat someone over the phone or internet will result in the Doctor being sued.
And that would be a wonderfully quick way to re-align all the AARP oldsters that were sold this bill of goods. 2012 would be a very good year for the R’s. Maybe we should let Berwick be confirmed.
Non-profit, huh; including the life-time health insurance for him and the missus, evev at government wages, he’s likely to miss the “non-profit” status:
“Questions have been raised about some of the successes his institute cites, however. In 2006, two researchers published an article questioning results of the institute’s 100,000 Lives Campaign, which said it had averted about 122,000 hospital deaths, largely by preventing medication errors and infections in 3,100 institutions over 18 months.
The researchers said 14 percent of the hospitals did not submit their data, and that all of the data submitted were unaudited.
Also that year, Modern Healthcare, a respected journal, questioned the accounting of various funds at the institute. It also noted that in 2003, Berwick earned a “whopping $769,000 in total compensation, followed by $639,000 the next year, including $110,000 for lifetime health insurance.’’ The organization’s tax filings for fiscal 2008 show Berwick was paid $637,000.”
Berwick is actually Professor Irwin Corey isn’t he?
I don’t know about doctors in the private sector, but as a military dependent, I’m beginning to think we were the guinea pigs for all of this. My doctors have been doing this via phone for some time. Not all visits mind you, but mostly follow ups. My dog gets better follow up care at the vet than we do.
There has to be a way for us to be responsible in our use of the system while being an advocate of our own healthcare. Too many seniors that I have known just automatically trust in the doctor's word and do no research.
The FIRST thing that should be done is to reign in the lawyers so that doctors are not forced to practice "defensive medicine."
I have a just-diagnosed condition for which I'm trying to take part in the decisions of my own care, but am running into "standard of care" in which one particular drug that may be life-saving for me can ONLY be dispensed along with two or three OTHER drugs due to this "standard" (read defensive medicine) and all three are horribly expensive.
This puts the decision into the hands of the insurance company...will they pay and how much for the three? The co-pays are horrendous. I am, at this point, "non-compliant" as in refusing further treatment while I search for an avenue that may be feasible for me. At the same time, on forums on the condition, I find that the same exact treatment is being given to nearly everyone, despite the severity of individual cases. It's a nightmare! And I fear it is only getting worse with Obamacare..."death panels" loom in my future.
Excuse me - I have to deal with patients making calls to me for referrals for psychiatrists, medication referrals by primary physicians and doctors make referrals to me for counseling and feedback on patients. The telephone calls are generally made late in the day, and the phone calls are not antiquated and outdated. the so called electronic medical record is supposed to go in effect next year. we will see how the big cities handle the volume of online medical record requests. This Berwick is not a medical doctor he has ideas and theories of others that he desires to see if they work. Ideas down on paper generally do not pane out on a massive scale. So lets spend 4 trillion dollars and if it fails, spend 8 trillion dollars and if it fails throw more money at it. Look at Odumbo and the Annennberg Challenge for Educational Reform in Shitcago - it failed after over 100 million spent on it and Shitcago educational deform ensued. Odumbo is a failure, Berwick is a failure. All these DUMBOCRATS Need to RESIGN
Harvard and so many other liberal bastions of stupidity need to close their doors forever. There will ba savings in billions close Harvard, Yale, Columbia University, Stanford, UCLA, UW- Madison Chicago University and many others that just suck off the teat of government and achieve nothing of lasting value
Thanks for the ping Nachum. I posted “Berwick is actually Professor Irwin Corey, isn’t he?”
Unfortunately Berwick isn’t a funny character as was the Professor.
I am a little confused on Dr. Don Berwick How can he be a peditrician, an professor of peditric medicine with no real experience as real peditrician. He regurgititates studies from the National Institute of healthand BS from the British Healthvare System. How is the largest Nationalized healthcare System working or not working in Great Britian. This guy is as useless as teats on a Boar Pig. Teats on a boar Pig, look good but have no useful purpose. Lots use the analogy of a neutered male cat - he has the ability to get it on, but no ability to do nothing other than shot blanks. Berwick is like the eunuchs for a king.
Odumbo is useless as a president.
Berwick should be removed immediately and the Senate should order his arrest and incarceration. 2011 this POS will be gone permanently. Just like Harvard should be closed forever.
My father just had a triple bypass at the age of 78. It’s a good thing this has been taken care of now, instead of showing up later. The bureaucrat would have told my father “Well, you have had a complete life. Just drink from this. You get your choice of color, scenery, and music for your final minutes.”
And then I get told “Fred, shut up and eat your green crackers”.
My father just had a triple bypass at the age of 78. It’s a good thing this has been taken care of now, instead of showing up later. The bureaucrat would have told my father “Well, you have had a complete life. Just drink from this. You get your choice of color, scenery, and music for your final minutes.”
And then I get told “Fred, shut up and eat your green crackers”.
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