Recently, while returning from a Yankees game, my friend had a serious car accident. She was in the passenger seat and her husband was driving. Unfortunately, her husband died almost instantly. My friend, badly injured, was intubated in the field and rushed to the hospital. She suffered broken limbs and intracranial hemorrhage (bleeding into the head). The first few days in the hospital were intense but miraculously she survived. She was in the Intensive Care Unit (ICU) for a month and is now recuperating in the rehabilitation unit of the hospital. The care she received in the ICU was topnotch. The care team did everything right and with absolute precision. Witnessing her recovery has urged me to remain proud of being a  physician and belonging to a cadre of professionals who are saving lives every day.

Our medical system is very well designed to respond to acute situations. We have the best hospitals and the best acute care facilities in the world. Physicians in these situations can function free of third party restrictions dictating what can and cannot be done. In acute medical situations, there is little time to deal with nonsense and the patient becomes the focal point and the doctor-patient interaction the essence of care.

This senario exposes the dichotomy in our healthcare system. On the one hand, we have amazing rapid response systems in place where care can be delivered without intrusion of special interests. On the other hand, we have a very lousy primary care and longitudinal care infrastructure, where the infridgement of third parties and other special interests has created a convuluted maze of ineffeciency leading to bad clinical outcomes. This shortcoming represents a great burden in terms of causing pain and suffering, lives lost, and economic strain, rapidly approaching the threshold of crisis.

Filed under: Health Policy