tag:blogger.com,1999:blog-32053362.post6585998453348493265..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: The US dialysis program -- How good and how bad?Paul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-32053362.post-37065026131101820162010-11-18T22:18:03.740-05:002010-11-18T22:18:03.740-05:00To dismiss the Pro Publica article out of hand is ...To dismiss the Pro Publica article out of hand is a great disservice to people like myself on dialysis at present. The take home message is showing how America is an outlier compared to other developed nations on how we deliver dialysis to our patients. <br /><br />Our poor outcomes are based on our profit driven practices that have been universally rejected by the other nations. Longer, slower and more frequent hemodialysis saves lives and returns people to higher function. Home, nocturnal dialysis has equal outcomes to cadaveric transplant, yet less than 1% of patients use this modality in America. Yet in New Zealand, they have over 25% of their patients on home, nocturnal dialysis. It is time for America to grasp that we have poor outcomes because we have the worst approach to dialysis as a developed nation.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-16864858927462274512010-11-17T10:10:45.790-05:002010-11-17T10:10:45.790-05:00Regina Herzlinger of HBS discusses the dialysis in...Regina Herzlinger of HBS discusses the dialysis industry in her book WHO KILLED HEALTHCARE? The contrast of practice specialization based on a technology (e.g. dialysis, MRIs) vs. condition (e.g. kidney disease, breast cancer) is important. The latter model is more patient-centered and comprehensive and lends itself to treating patients rather than organs.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-16131870544365024262010-11-17T08:25:34.974-05:002010-11-17T08:25:34.974-05:00As I was first employed as a hospital administrato...As I was first employed as a hospital administrator in the early 1970's the Nephrology industry got Congress to approve Medicare payments to Dialysis doctors and paid for the patients on a per Dialysis basis.<br /> <br />On the other hand (I sound like Tevye in Fiddler on the Roof), my grandfather died of kidney disease at age 54 in 1954, when there was no treatment.BMnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-49835591706817335522010-11-17T04:40:21.509-05:002010-11-17T04:40:21.509-05:00I read the Atlantic article and I agree with the p...I read the Atlantic article and I agree with the points you make. <br />Dialysis is not perfect, but it keeps people alive. The medical directors at most units are highly committed to taking good care of kidney failure patients.<br /><br />Of course, the ultimate solution to this problem is not making dialysis better, but preventing and treating kidney disease before it progresses to "end-stage" kidney failure. Polio was not cured by improving the iron lung!A nephrologistnoreply@blogger.com