Comments on: My take: Preventive care, Atlas, $$$, Grady bailout http://www.kevinmd.com/blog/2008/04/my-take-preventive-care-atlas-grady.html medical blog Sun, 22 Nov 2009 14:15:05 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2008/04/my-take-preventive-care-atlas-grady.html/comment-page-1#comment-84909 Anonymous Wed, 09 Apr 2008 05:46:00 +0000 http://clients.emmense.com/kevinmd/2008/04/my-take-preventive-care-atlas-grady-bailout.html#comment-84909 As a former Grady resident, I have fond memories of the place and all that I learned there.<br/><br/>That said, all public hospitals have financial issues. Grady has even worse financial problems. There are more "middle managers" and administrative types than there are residents, nurses, and janitors comibined. It makes the other public hospitals in the US look efficient by comparison.<br/><br/>Atlanta, and indeed all of Georgia, needs Grady, and it needs Grady to function. But it ought to include some sort of real management firm (?Hunter group?) along with the gift of $20 million.<br/><br/>Otherwise Kevin's predictions (that Grady will soon be bankrupt again) will be correct within months.<br/><br/>And, as to anon 7:21 - you're right. As long as it's easier to say "whatever the family wants" instead of "whatever is in the pt's best interest" the current chaos will not change much. As a former Grady resident, I have fond memories of the place and all that I learned there.

That said, all public hospitals have financial issues. Grady has even worse financial problems. There are more “middle managers” and administrative types than there are residents, nurses, and janitors comibined. It makes the other public hospitals in the US look efficient by comparison.

Atlanta, and indeed all of Georgia, needs Grady, and it needs Grady to function. But it ought to include some sort of real management firm (?Hunter group?) along with the gift of $20 million.

Otherwise Kevin’s predictions (that Grady will soon be bankrupt again) will be correct within months.

And, as to anon 7:21 – you’re right. As long as it’s easier to say “whatever the family wants” instead of “whatever is in the pt’s best interest” the current chaos will not change much.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/04/my-take-preventive-care-atlas-grady.html/comment-page-1#comment-84903 Anonymous Wed, 09 Apr 2008 01:16:00 +0000 http://clients.emmense.com/kevinmd/2008/04/my-take-preventive-care-atlas-grady-bailout.html#comment-84903 Primary care as preventive care misses the mark and misses the opportunity to make a real difference. Much of the expenditure of massive resources in the last month of life, much of family members wanting "everything done" is avoidable when instead of primary care, what one has is comprehensive care by a trusted family physician who has been through all the ups and downs with the extended family, who takes care of their patient with the occasional consultant. It is nearly a dead model now but was the norm 30 years ago. In that scenario, there is someone with a trusted authoritative voice who can say "I don't think you want to do that" or "It is time to back and let nature's take it's course". Primary care as preventive care misses the mark and misses the opportunity to make a real difference. Much of the expenditure of massive resources in the last month of life, much of family members wanting “everything done” is avoidable when instead of primary care, what one has is comprehensive care by a trusted family physician who has been through all the ups and downs with the extended family, who takes care of their patient with the occasional consultant. It is nearly a dead model now but was the norm 30 years ago. In that scenario, there is someone with a trusted authoritative voice who can say “I don’t think you want to do that” or “It is time to back and let nature’s take it’s course”.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/04/my-take-preventive-care-atlas-grady.html/comment-page-1#comment-84902 Anonymous Wed, 09 Apr 2008 00:21:00 +0000 http://clients.emmense.com/kevinmd/2008/04/my-take-preventive-care-atlas-grady-bailout.html#comment-84902 "As long as there are family members who "want everything done", and back that up with threats of lawsuits, physicians will have little say in the matter."<br/><br/>As long as we have physicians who are unwilling to do their jobs or for that matter take control of their financial situations, and blame everyone else for those failures, not much will change. “As long as there are family members who “want everything done”, and back that up with threats of lawsuits, physicians will have little say in the matter.”

As long as we have physicians who are unwilling to do their jobs or for that matter take control of their financial situations, and blame everyone else for those failures, not much will change.

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