Comments on: Do Patients Receive About Half of Recommended Health Care?

By: Coco

Coco — Fri, 18 May 2012 06:56:17 +0000

Hollybank have taken care of our pets for about 1 yr now. We have 2 dogs, Jasper and Bessie; before them was our llevoy Dexter who very sadly is no longer with us. Everyone at Hollybank is so helpful and always at hand to answer our queries, whatever it maybe, from healthcare advice, behaviour issues, worming all sorts of things! When you arrive with your pets at Hollybank it feels like walking into someones home where you always get a warm welcome. It doesnt feel like some vetinary practices do, which can often be a clinical, scary place! All our pets have been relaxed and happy to walk in! The facilities at Hollybank are fab I have total piece of mind that my pets are receiving the BEST possible care and are in great hands (especially with the 24hr contact service too). Totally recommend them Thank you.

By: fm radio stations in Alabama

fm radio stations in Alabama — Wed, 29 Sep 2010 19:47:53 +0000

With regard to the Rand Studies, I defer to a quote from a fellow Missourian who said: “Statistics are like a lady of the night, once you get them down, you can do anything you want with them.” Mark Twain

By: Joetta Wilkus

Joetta Wilkus — Tue, 17 Aug 2010 11:45:10 +0000

Hereditary Factors Is What Causes Acne Breakouts-As I said earlier some causes of acne are inevitable. This is a good example of a cause of acne that we can’t avoid. Acne can be inherited and some serious acne causes such as Cystic acne do come from heredity like through family members such as our parents and grandparents.

By: RAND Study Slammed | John Goodman | NCPA

RAND Study Slammed | John Goodman | NCPA — Thu, 03 Sep 2009 15:30:50 +0000

[...] of recommended care when they see physicians? David McKalip disputed this RAND study finding in a previous post. Here is another response: That study was supposed to be based on telephone interviews with 13,000 [...]

By: Beverly Hills- A Perfect Place for Cosmetic Surgery | A Womans Life

Beverly Hills- A Perfect Place for Cosmetic Surgery | A Womans Life — Sun, 14 Jun 2009 16:14:49 +0000

[...] Do Patients Receive About Half of Recommended Health Care? | David … [...]

By: Bret

Bret — Wed, 10 Jun 2009 13:51:12 +0000

Very good analysis. Comparable to the Goodman/Musgrave anaylsis in Patient Power on an earlier RAND study. Most people never take the time to look beyond the headlines.

By: Stephen C.

Stephen C. — Tue, 09 Jun 2009 12:33:14 +0000

David:

Thanks for doing this.

By: David McKalip

David McKalip — Mon, 08 Jun 2009 21:20:40 +0000

Thanks All.
To Larry,
Medicine is more science than art and it deals with individual management in ways that requiring the juggling of hundreds of rapidly changing variables for each patient. Thus, I believe, it is impossible to create “process meausures” that will alow one-size-fits-all medicine without causing many many uninteded consequences.

The practice of Medicine is hard. It requires much study, dedication and improvizaiton. The data on application of “process measure” compliance shows that such compliance does not improve outcome.

All of our efforts in health care reform ar cost driven. Look at Obama’s #1 goal. The best way to deal with an economic problem (high cost) is to apply the most powerful tool for reducing costs and improving quality: free market forces.

Using process measures as a means of decreasing costs is using central planning. We all know how that always fails.

Let doctors practice medicine. Pay them for their time. choose the ones that produce the results you want as a patient. The rest will follow naturally. As for the social problems of “the uninsured” etc…, well that is simply politics.

By: Joe S.

Joe S. — Mon, 08 Jun 2009 20:45:55 +0000

This was a very thoughtful, very well done post.

By: Larry

Larry — Mon, 08 Jun 2009 16:54:34 +0000

This is a very interesting analysis. First, a few observations. While there is a significant amount of time and money spent on clinical tests, test equipment and procedures, there is relatively little spent on process. We know, through the efforts of many Lean Six Sigma companies that processes that are developed exhibit a great deal of variation and waste unless there is concerted effort to develop the process using tools similar to those used in Lean Six Sigma effots (e.g., DMAIC, DfLSS, etc.)

There is relatively little process technology that enables aggregated feedback to providers relative to how they have treated patients and the outcomes of those decisions.

The work of the Wennberg and Fisher (Dartmouth Atlas) clearly demonstrates that health care is supply driven.

Everyday, it seems, there are articles about the efficacy of a new drug or procedure compared to its predessor drug or procedure. Often those comparisons are not favorable (see the recent WSJ journal article on drugs and procedures for Type 1 diabetics). Follow stories such as these at http://www.ilovebenefits.wordpress.com

So we have a sector of the economy health care which is hardly a system that has a large proportion of it acting as a cottage industry. This industry has little (compared to other industries) very little in the way of process technology and measures. Communities act independently of one another.

The RAND study, should be seen as what it is, a clarion call for process, measures and consistency around what we do know and what existing technology and systems thinking can deliver to improve the health outcomes of all Americans.