tag:blogger.com,1999:blog-32053362.post2289305827101095176..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: Why is this news? Why is it new?Paul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-32053362.post-10985735596961332642015-03-08T16:45:18.068-04:002015-03-08T16:45:18.068-04:00I will say this, sadly, better late than never. Th...I will say this, sadly, better late than never. The first thing a person wants is a warm hand, start the ball rolling in whatever manner. Pity we couldn't do that now where I'm at. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-12312040397710542712015-03-08T01:53:30.886-05:002015-03-08T01:53:30.886-05:001. I misunderstood that this involved patients wit...1. I misunderstood that this involved patients with cancer diagnosed at BWH/DFCI being able to get more timely appointments. I agree with that, and we strive to provide appointments as soon as possible after diagnosis so patients can have the needed discussion & planning. When slots are not available, other doctors and I find ways to accommodate urgent cases.<br /><br />2. My prior experiences with referring patients to DFCI for second opinions sometimes did require some extra time because of outside specimens needing to be transported to their pathologists for review.Peter Yang, MDhttp://hemonc.org/wiki/Main_Pagenoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-21810218470409570182015-03-07T11:01:30.870-05:002015-03-07T11:01:30.870-05:00"I hope and trust..."
Surely, Paul, you..."I hope and trust..."<br /><br />Surely, Paul, you know your trust is misplaced. Most doctors, even those treating cancer, care first and foremost about their own comfort and their own schedule. Sad but true.<br /><br />A friend had esophageal cancer diagnosed just over a year ago, and I couldn't believe how relaxed they were when treatment would start, etc. Their own schedules came first!Bobnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-89345960705777519312015-03-07T09:45:55.153-05:002015-03-07T09:45:55.153-05:00I think this illustrates a nearly universal proble...I think this illustrates a nearly universal problem: our health and illness care systems are organized largely to meet the needs of the system rather than patients.<br /><br />Health care is not unique. I think John Gall in Systemantics summed it up well when he pointed out that complex systems inevitably end up working against the purposes for which they were initially intended. <br /><br />It would not be a perfect solution, but I think a start would be to have patients as a large and powerful (i.e., not token) participant in planning and governance of all health care institutions. If they are not at the table, it means they are on the menu.pheskihttps://www.blogger.com/profile/16102200723940843059noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-35955262287031896892015-03-07T08:32:16.269-05:002015-03-07T08:32:16.269-05:00Sorry, I don't buy that. This is not about re...Sorry, I don't buy that. This is not about reviewing an "outside" path report. It was produced by their own folks.<br /><br />Also, there is still room for the second opinion if you have an immediate appointment with the patient. Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-50031509712226635562015-03-07T07:21:37.941-05:002015-03-07T07:21:37.941-05:00I haven't worked at DFCI, but I believe one re...I haven't worked at DFCI, but I believe one reason why they needed time before seeing new patients is that they had a standardized process for obtaining records and reviewing outside data prior to the first consultation. Most notably, they would obtain the outside pathology/biopsy sample and have their own staff review it to confirm the diagnosis. That IS an important part of the second opinion process and different conclusions have certainly influenced treatment choices, so a tradeoff to the faster appointment--if they sacrifice requiring that review beforehand--may be that there will be an incomplete set of information available at that first appointment to discuss or the possibility that the treatment recommendation will need to change.Peter Yang, MDhttp://hemonc.org/wiki/Main_Pagenoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-13190154212607478442015-03-07T06:05:35.451-05:002015-03-07T06:05:35.451-05:00Their advertisement does seem to smack of an airli...Their advertisement does seem to smack of an airline advertising "Our plane has wings."beverlyhttps://www.blogger.com/profile/13640602293864876951noreply@blogger.com