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February 1, 2012

Houston, We Have a Problem …


7 Comments to “Houston, We Have a Problem …”

  1. Bill Anderson said,

    February 1, 2012 @ 2:34 pm

    Alan, sounds a lot like the system in the UK, or like many HMOs in this country. They take on a life of their own, and as you commented, lose track of why they’re there.
    I enjoy your blog.

  2. Allen Nissenson said,

    February 1, 2012 @ 2:44 pm

    Thanks for the comment, Bill. Very frustrating despite so many well-meaning people.

  3. Jonathan Philipson said,

    February 7, 2012 @ 1:23 pm

    Allen, What a nightmarish system for something that could have been taken care of so much more efficiently. I often wonder if things would improve if the CEO of that hospital or system was required to spend a day or week as an “undercover boss”. And maybe that’s something that could or should be done in the DaVita community. It would undoubtedly make the quality of care that we provide even better and perhaps make the transition to the dialysis world easier on our patients.

  4. Allen Nissenson said,

    February 7, 2012 @ 3:41 pm

    Great idea- I just saw that show the other night for the first time and it was impressive.

  5. Tracy Olsen said,

    February 23, 2012 @ 3:30 pm

    Am wondering if you have read The Healing of America by T.R. Reid, and if you think any aspect of it would work in this country.
    I don’t know that I agree with Bill Anderson that HMO’s necessarily provide less than good care. Many years ago, as a young health care professional, my first experience with my own health insurance was Kaiser. I was very impressed by the “mutiphasic”, a series of screening tests. More recently, when my son was in college in San Diego, I signed him up for the Kaiser Plan. I was again impressed by the coordinated care that was provided.

  6. Allen Nissenson said,

    February 23, 2012 @ 3:46 pm

    You would be interested in the latest NEJM- now online- excellent article about Medicare Advantage plans- showing quality comparison with FFS and comparing quite favorably. In addition, some HMOs already have excellent EHRs- these are key as we move to more integrated care/ACOs.

  7. SAM said,

    April 2, 2012 @ 8:46 pm

    Allen,
    It sounds like when my late husband was at Mayo. Friday night, simple procedure. The removed the catheter on his neck after he went into Kidney failure and then placed it in his chest.
    Unfortunatley the radiologist nicked his corotid artery in the process. I walked in and his bed was dripping witth blood. The on-call surgeon would not come in because he was at his dude ranch in AZ and said it will “clot”.
    The nurse called 5 times and after 4 hours and emphasizing Jim was on Hepperin he came in.
    Jim was forced to have a transfusion the next day.
    The surgeon immediately covered his ass by not telling the tranplant team, Later that year (after the staute of limitations were up, the dr.s told Jim that his antibodies were too high and even though my sister was a match (I had given him mine in 2000 no dialysis) and he would never receive a kidney.He died at 46.


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