tag:blogger.com,1999:blog-32053362.post4671891636319562865..comments2024-03-29T06:37:18.029-04:00Comments on Not Running a Hospital: Transplantation Darts and LaurelsPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-32053362.post-77374573531468482952007-02-01T09:50:00.000-05:002007-02-01T09:50:00.000-05:00Anon,
We did not pursue heart or lung transplants...Anon,<br /><br />We did not pursue heart or lung transplants.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-31912497819422609492007-02-01T09:41:00.000-05:002007-02-01T09:41:00.000-05:00I'm quite surprised at the Globe blog's words. Fu...I'm quite surprised at the Globe blog's words. Fundamental journalism skills including carefully choosing one's wording to be accurate about what did and didn't happen. The blog did a poor job of that.... it's more like advocacy journalism, a tabloid, or a gossip column. Somebody deserves reproach, gentle or otherwise.<br /><br />Is the Globe affiliated with (or a fan of) any particular health care provider in the Boston area?<br /><br />Another possibility, which I shudder to think about, is the reality that some bloggers writing mildly flaming things as "linkbait," i.e. hoping to get others to link to their article, which supposedly means you're a cool blogger. That may be appropriate for things like the Drudge Report, but it ought to be out of bounds (as a matter of policy) for an operation like the Globe.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-79292735198543300082007-02-01T09:03:00.000-05:002007-02-01T09:03:00.000-05:00Your comments about what other hospitals should or...Your comments about what other hospitals should or should not be doing would carry greater weight for me if you can give some examples where BIDMC decided to not pursue, or drop, a service line because the service was adequately provided at other locations. I'm sure there are some examples, aren't there?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-25171432990355769052007-01-31T19:38:00.000-05:002007-01-31T19:38:00.000-05:00While attempting to duplicate patient care activit...While attempting to duplicate patient care activities across two hospitals may not be a great plan, combining the expertise between transplant programs may be an excellent opportunity. It should allow the centers to collaborate on research projects, share clinical insights from their differing strengths, and expose fellows in transplantation to a greater breadth of practice. A similar collaboration exists in the <a href="http://www.georgetownuniversityhospital.org/body.cfm?id=1664">Washington DC area</a> between Georgetown, Washington Hospital Center, and the NIH. I'd be curious to see more clearly what the Lahey and UMass programs' intentions are, and how the DC collaboration has worked out.<br /><br />As for volume and outcome, a transplant surgeon at Dartmouth gave a <a href="http://67.59.131.78/presentations/asts/exported/saturday/axelrod_content.htm">talk</a> on this topic about a year ago. Overall, the research on this question in transplantation is mixed (some shows an effect, some doesn't). But it seems positive that Dartmouth is active in researching this question on a large scale as they consider the implications for their own program.<br /><br />For more "darts and laurels" or general thoughts and issues on transplantation, I've started a blog recently: <a href="http://transplantheadquarters.blogspot.com">Transplant Headquarters</a>.Manu Varmahttps://www.blogger.com/profile/05200309838587779244noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-3798396254414217142007-01-31T19:28:00.000-05:002007-01-31T19:28:00.000-05:00The Globe's White Coat Notes blogs describes what ...The Globe's White Coat Notes blogs describes what I just said in this blog, as follows:<br /><br />"Levy pans joint liver transplant program -- Paul Levy has harsh words for the new joint program for liver transplantation between Lahey Clinic and UMass Memorial Medical Center. Both transplant centers will continue to function independently, with surgeons operating in Burlington and Worcester, undermining the promise of collaboration, he writes in his blog today."<br /><br />I just have to say that I don't think I "panned" this program, although I clearly stated a disagreement with one of its features. I termed this a "small dart" for something that could otherwise be a "big laurel." Also, I don't think I used harsh words.<br /><br />What do you think?<br /><br />I end up feeling I should apologize to Lahey and UMass Memorial for this characterization of my posting, but, then again, I didn't write it! I stand by what I said, and I chose the words I used quite carefully.<br /><br />I am not complaining - just observing. Really. The virtue of this medium is that it gives everyone the ability to make his or her judgments, and then post them.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-76407282613011967682007-01-31T14:26:00.000-05:002007-01-31T14:26:00.000-05:00The concept of rewarding the highest quality, most...The concept of rewarding the highest quality, most cost-effective providers with more patients that Porter and Teisberg wrote about in their book, Redefining Healthcare, is especially relevant to organ transplants which are, by their nature, complex and expensive procedures. The more complete information, at least about outcomes data, that can be made available to both patients and doctors, the better. To the extent that the team and the hospital may be as important as the surgeon in determining overall outcomes, surgeons should, presumably, have a vested interest in practicing in the best possible environment.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-36830724721119014372007-01-31T11:03:00.000-05:002007-01-31T11:03:00.000-05:00For some surgical procedures, hospital volume pred...For some surgical procedures, hospital volume predicts better outcomes than surgeon volume. It may be a team effect. I don't know what the data are for liver transplants, but I imagine moving the surgeons around - as individuals - to populate a small program would not, as you say, produce the critical mass you need for quality.Emily DeVoto, Ph.D.,https://www.blogger.com/profile/15360761251097036916noreply@blogger.com