Sunday, August 23, 2015
Doctors or Systems?
We used to think that the best way to be assured of good
medical care was to put ourselves in the hands of the right physician.
It appears not to be that simple any more.
The July issue of H&HN, the journal of the American
Hospital Association, included an article entitled When Stroke Care is a Statewide Effort. The article began by reciting the story of a
stroke victim in Illinois who was taken to a 25-bed hospital in Taylorville
rather than to a larger hospital in Springfield. The patient’s wife questioned that decision
and was assured by the local doctor that it was the right thing to do. The patient got a quick CAT scan, followed by
a dose of tPA, the clot-busting drug, and was then shipped off to the larger
Memorial Medical Center in Springfield. By the time the
patient arrived there, his previously paralyzed left side was working again.
The rest of the article discussed the Paul Coverdell
National Acute Stroke Program. Coverdell
was a U.S. Senator from Georgia who died of a stroke. The program named for him is operated by the
Atlanta-based Centers for Disease Control and Prevention and sponsors stroke
systems of care. These programs involve
coordinating the activities of Emergency Medical Technicians and hospitals so
that stroke victims receive appropriate treatment promptly – time being of the
essence in this case.
So it seems that if, God forbid, you should suffer a stroke,
the quality of the care you receive may depend more on the system that provides
it than on the identity of the doctors who staff it.