Number 1 is Rescue and Repair
Trauma Care
At the top of the list is Trauma Care. That
has long been the primary job of physicians and staff. The ER is the normal entry point and the case
is life-critical. This often requires an
OR at the ready. If the patient is bleeding heavily, not able to breathe, heart
attack, etc. The rescue is to keep the
patient alive; the repair is to do surgery or administer drugs and “repair” the
patient to stabilize and heal. If the
patient isn’t breathing, you will need to do CPR immediately; don’t wait for
the EMTs. Life-critical trauma care is
the only resource we need to be available.
Now comes the expensive part. Too many
expensive tests, monitoring and long hospital stays need to be avoided. So,
malpractice law needs to be reformed to eliminate defensive medicine practices.
I would eliminate malpractice suits completely and leave discipline to the
local Medical Societies. If we fix this,
maybe the healthcare industry will survive.
Number 2 is Scheduled Surgery
Having a hernia fixed requires an OR. Baby delivery in a hospital is common. If the
baby isn’t turned, or is tangled up in the umbilical cord, somebody needs to
either fix it or make the call to deliver via caesarian surgery. That’s when
the sonogram should be taken.
Number 3 is Normal Care
For care of things that are not
life-threatening, most things can be nursed at home and you can wait until
morning to go to the doctor.
If little Johnny falls out of a tree and breaks his arm,
put cold packs on it and take him to a doctor’s office if you can get one. The ER is 24x7, but it is 7 times more
expensive than the doctor’s office or emergency care office.
If there is EXTREME PAIN it could be an appendicitis or
worse, so the ER is the place to go.
Home healthcare is the future for most
patients who suffer from progressive disease.
Chronic illness patients need to shop around for dialysis, etc.
Number 4 is Recovery Therapy
Physical therapy can help with brain injury cases, but
they tend to be “stretched-out” way beyond what’s needed. Also, they won’t
catch things like post-op infection control or frozen shoulders. You need
specialized help for that.
Number 4 is Counseling & Mental Health
Decades ago we didn’t have much of this. This was an out-of-pocket expense. Most of this is up to the patient and can be
done for free. There are AA groups and other resources. A few years ago,
counseling for addictions was stretched out beyond what was needed, but now it’s
short. Real psychotics are either in hospitals or in elective office.
Number 5 Prevention
Prevention is really the responsibility of the patient
and shouldn’t require any cost. There are health fairs where you can get a
sonogram of the plaque in your arteries, etc.
Trends
Baby delivery Home birthing in blow-up water pools is
being done by experienced visiting nurses, but they need to bring a sonogram
machine and a fast car if the baby is wrapped up in the cord or is positioned
to come out feet first.
The internet can answer any questions you have about
medications, symptoms, etc.
Norb Leahy, Dunwoody GA Tea Party Leader
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