Author Archives: Davis

Doctors are professionals.  But are doctors cowboys or pit crews?  Recently, physician writer, Dr. Atul Gawande, spoke about the challenges for the next generation of doctors in his commencement speech titled, Cowboys and Pit Crews, at Harvard Medical School.  Gawande notes that advancement of knowledge in American medicine has resulted in an amazing ability to provide care that was impossible a century ago.  Yet, something else also occurred in the process. “[Medicine’s complexity] has exceeded our individual capabilities as doctors… The core structure of medicine—how health care is organized and practiced—emerged in an era when doctors could hold all the key information patients needed in their heads and manage everything required themselves. One needed only an ethic of hard work, a prescription pad, a secretary, and a hospital willing to serve as one’s workshop, loaning a bed and nurses for a patient’s convalescence, maybe an operating room with a few […] Read More »

The future direction of American health care is unclear.  Certainly the cost trend as it exists is unsustainable with health care costs being a major concern of the private sector, the government, and individuals.  How does the nation manage costs while ensuring high quality medical care, access, and service?  Proposals include increasing competition among insurers, providers, and hospitals to drive down prices or giving more financial responsibility to patients via higher deductibles and co-pays with the belief that they will demand price transparency, shop around for the best price, and as a result slow health care costs. What if both ideas are wrong? While it is possible these plans might work, I cannot help but notice the similarities in the challenges for patients in navigating the health care system and consumers figuring out how to purchase and use technology.  Walk into your neighborhood electronics store.   Individuals are overwhelmed with […] Read More »

In 2006, the New England Journal of Medicine published a study that found regardless of an individual’s socioeconomic, demographics, and health care insurance status that uniformly Americans only received the recommended medical care just a little more than half the time. Slightly better than a coin flip. Perhaps more concerning is what was not said, – our nation does not have the desire or the plan to overhaul and implement the “large-scale, system-wide changes” to our dysfunctional health care system needed to provide quality health care to all. Two-thirds of Americans currently rate the health care system as fair or poor. Fewer employers are offering health care insurance to their workers and retirees due to unstoppable increases in premiums. Instead of improving the system, the federal government and health care insurers major focus is the active promotion of health savings accounts and consumer driven health plans with high deductibles. By […] Read More »