By John Ballard
Most readers will find this subject dry, technical and too obscure to follow so I will try to make this short and sweet. Reform is about more than the money and politics getting most of the attention. It is about getting better outcomes quicker and more economically, knowing that for good providers there will never be a shortage of demand.
Dr. Robert Wachter's Christmas Eve post at the Health Care Blog, Hospitalist Co-Management Of Neurosurgery Patients, is a message by a professional, written to be understood by other professionals, not aimed at us laymen. But I have followed the health care reform discussion long enough to know he's talking revolutionary stuff here. Here are a couple of notes for those who want to check out the link.
?Hospitalist is a recent term referring to an emergent specialty, a physician generalist assigned to a hospital environment. This is not the same as doctors who work in clinics and providers not IN the hospital but which use hospital resources as part of their mission. I explained this term in an October post.
?Abbreviations you should know...
- CNS - Co-Management with Neurosurgery Service. Dr. Wachter explains
- FTE - Full Time Equivalent A payroll measurement of time which measures and tabulates part-time work into full-time common denominators for scheduling, budgeting and accounting purposes.
- HOT - Hospitalist-Orthopedic Team. A mayo Clinic team approach to managing orthopedic cases in preparation for earlier discharge following surgery. Laymen often use words like medical and surgical carelessly. But professionals in the hospital environment do not consider them the same. Read carefully to sense the difference.
- Rounding. This is doctor-speak for "making rounds" as in "rounding on every patient, every day."
- DVT prophylaxis. Deep Vein Thrombosis prevention. DVT is a dangerous condition that can affect anyone whose legs are not moving for extended periods of time. Hospital patients are now routinely fitted with pneumatic leg covers which gently massage their legs which keep blood circulating to prevent the formation of blood clots. (I'm waiting for the airlines to furnish similar equipment on request for passengers on long flights at risk for the same condition.)
- CHF. Congestive Heart Failure. Unlike its more dramatic cousins, acute stroke and heart attack, congestive heart failure, though moving in slow motion, is no less life-threatening.
- CMO. Chief Medical Officer.
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Two concepts not mentioned by Dr. Wachter are Accountable Care Organization and Medical Home. Both of these terms are also part of the emerging vocabulary of health care reform and represent important changes away from the fee-for-service model that has nearly led to the self-destruction of medicine in America. I see Dr. Wachter's CNS as a step in the right direction. The sooner we develop and pay for best practices rather than shotgun efforts the quicker we will all be better off.
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