More On Getting Doctors Involved

Ezra Klein:

You should stop reading my blog and go read the commencement speech Atul Gawande gave to the students at Harvard Medical School. I’ll post some thoughts on it later. For now, I’ll just say that the conversation Gawande is having about the role of the doctor in the modern health-care system is, in my opinion, the single most important conversation in health-care policy right now, and that’s true whether you’re talking about controlling costs or helping people live longer and healthier lives. But it is not, in any way, a conversation Washington is equipped to participate in, or even interested in having.

From Gawande's speech:

Not long ago, I had an experience at our local school that brought home the stakes. I’d gone for a meeting with my children’s teachers, and I ran into the superintendent of schools. I told him how worried I was to see my kids’ art classes cut and their class sizes rise to almost thirty children in some cases. What was he working on to improve matters? I asked.
“You know what I spend my time working on?” he said. “Health-care costs.” Teachers’ health-benefit expenses were up nine per cent, city tax revenues were flat, and school enrollment was up. A small percentage of teachers with serious illnesses accounted for the majority of the costs, and the only option he’d found was to cut their benefits.
“Oh,” I said.
I went to the teacher meetings. On the way, I ran into a teacher I had operated on. She’d had a lymphoma. She was one of that small percentage who accounted for most of the costs. That’s when it struck me. I was part of the reason my children didn’t have enough teachers. We all are in medicine. Reports show that every dollar added to school budgets over the past decade for smaller class sizes and better teacher pay was diverted to covering rising health-care costs.
This is not inevitable. I do not believe society should be forced to choose between whether our children get a great education or their teachers get great medical care. But only we can create the local medical systems that make both possible. You who graduate today will join these systems as they are born, propel them, work on the policies that accelerate them, and create the innovations they need. Making systems work in health care—shifting from corralling cowboys to producing pit crews—is the great task of your and my generation of clinicians and scientists.

The whole thing is excellent.  Ironically, yesterday I went to a graduation party for a neighbor's daughter who just got her medical degree from a prestigious university.  Some of her family members were asking about what she'll do in residency and she was explaining going on rounds with the chief of surgery.  After she explained what all she had to do, somebody asked her how she kept everything straight.  She said she has to make a list, such as, "Give xx cc of this to this patient in 4 hours."  They asked about how she will remember to so that in 4 hours.  Her answer was to check the list every chance she gets.  I asked why couldn't they use an iPad or iPhone-type device, and she said it would be too time consuming to type all that stuff in.  I can understand that, but I would think being able to set alarms to remind you would more than offset some of the difficulties, especially if some speech-recognition system could record and enter the important data for them.  It would seem like if Ford can put their "Sync" system in a low-end model like a Focus, we could get better IT equipment than a notepad for doctors.