Tuesday, February 21, 2006

Comments from Kelly

Fellow alum John Kelly, long-time health care executive and now consultant, responds as follows to some recent postings:

On McNulty’s Comments: The thought that doctors would practice medicine without the threat of trial lawyers can/should only be considered when we also craft systems whereby the is no NEED for trial lawyers. More reflection on what Dan Ford is suggesting is in order – or – as Donald Berwick has said “nothing about you without you” and this should include investigations into errors of omission and commission. The patient (or representative) should be involved in a full disclosure process.

On the use of Non-physician practitioners: Let’s even take it a step further and create systems of care for which the individual patient/person can direct themselves to health. Here’s a practical example (as a father of little children yet): every parent should be instructed in the proper use of the otoscope before they can take their kid out of the nursery. This would allow the parent to evaluate almost every fever of more than 3 days duration to rule out ear infections and save thousands of visits to the doctor. Okay, perhaps a silly example, but you get the point. If we expect people to dial in to ‘troubleshoot’ their computer…why not for their healthcare? Put the tools in the hands of the patient in a true extension of the physician (or non-physician practitioner) practice.

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