Uncategorized

INTERNATIONAL/QUALITY: Reggie will be having a fit

I’ve always been amused that the most cited example of the “focused factory” that Reggie Herzlinger perceives to be the answer to  medical cost and quality problems is the Shouldice Institute in Canada. That’s right the country where it takes ten months to get a doctors appointment if you’re pregnant, and where the state controls all health care—concepts Reggie’s not so keen on.

And of course the nearest thing to focused factories in the US are the specialty hospitals which—given our incentives—make most of their money increasing the amount of care given to a set populations (probably unnecessarily) and taking the most profitable cases away from the local community hospitals and away from their mission of care, or their fat endowments (Delete half the previous phrase based on your stance on the matter).

On the other hand if focused factories were established within a cost-constrained environment, presumably we’d get a clue as to whether they are more efficient and save money over all. Well maybe we’re going to find out.

Apparently London is going to be transformed into a city of 200 large multi-specialty group practices with what sounds like specialty hospitals to handle the acute care. This is going to be very interesting.

Meanwhile, in Southern California a doctor buys hospitals, kicks out managed care, jacks up prices and makes bank. Tthat’s real value add to the system

Livongo’s Post Ad Banner 728*90

Categories: Uncategorized

Tagged as: , ,

10
Leave a Reply

10 Comment threads
0 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
9 Comment authors
Venus Factor ,diet plans for womenGarfield HadlerRoosevelt StrumpfTheresa MorrisSOHRN Recent comment authors
newest oldest most voted
Venus Factor ,diet plans for women
Guest

Highly descriptiv article, I enjoyed that a lot.

Will there be a part 2?

Garfield Hadler
Guest
Garfield Hadler

Hernia is painful specially if you got a surgery and recovering from it. ,

Take a look at all of the most recently released write-up on our new blog page
http://www.healthmedicinelab.com/e-coli-in-urine/

Roosevelt Strumpf
Guest
Roosevelt Strumpf

Hernia can be best remedied through surgery. Hernia can be also hereditary and there is not much you can do about it. `:`,.

Enjoy your weekend! http://foodsupplementdigest.com/5-htp-dosage/

Theresa Morris
Guest
Theresa Morris

Im writing in response to the above letter. My son was killed by the procedures and policies of Prem Reddy( I hesitate to put Dr in front or behind his name). My son was in a car accident and was taken to Desert Vally Hospital. Dr Michael Manalescu was the ER doc, he is not certified in er medicine. He gave him xrays overdosed him with fentenyl and released him. He was coding at our house about 6 hours later. The paramedics took him back to Desert Valley Hospital and there as no er doc on duty, just a PA.… Read more »

SOHRN
Guest
SOHRN

I am employed by Prime Healthcare and can tell you that the hospital ICU is chronically understaffed. There is a law in the State of California which says that there is to be 1 nurse for every 2 patients in the ICU “AT ALL TIMES”. That means when a nurse goes on a break, takes a patient for CT Scan, etc, there is to be another nurse to watch her patients. Well there isn’t. And we don’t get paid overtime for missing breaks, we’re told we MUST TAKE OUR LUNCH BREAKS. Nurses sometimes work 24 hours shifts because when the… Read more »

Tom Leith
Guest
Tom Leith

> My research shows that Shouldice does NOT want > to expand as it would reduce the excellant quality > control that Shouldice now has. Shouldice has faced a number of management issues ranging from regulatory challenges to succession planning. My research shows that expansion was being condidered at one time, that there was internal debate about what that would mean operationally, and indeed quality of care was one topic. But not the only one. In any case, its moot whether they want to expand. > Now some information about how Canada > is trying to improve service Let’s see:… Read more »

Peter
Guest
Peter

“Shouldice Hospital has been operating on hernias since before World War II. The non-profit hospital has used its unique surgical technique to bring relief to more than 300,000 patients. Called the “Shouldice Technique” or “Canadian Method,” Shouldice Hospital’s approach to hernia surgeries has been admired replicated around the world. Located just outside Toronto on a picturesque country estate, Shouldice boasts 89 beds and impeccable patient care. In the public system, hernia surgeries are usually treated as day surgeries – the patient arrives in the morning, receives the surgery and goes home to recover. At Shouldice, patients are asked to stay… Read more »

Barry Carol
Guest
Barry Carol

Dr. Prem Reddy’s business model and strategy seems, I think, to call for a legislative response that would limit the amount that could be charged the uninsured and insurers who do not have a contract with his hospitals to 125% or, at most, 150% of Medicare rates, though they could agree to reimburse at a higher percentage for certain procedures that Medicare pays poorly for as part of a contract if they think it is necessary. I believe Maryland already has a legislative limit of 125% of Medicare that hospitals can bill the uninsured. Hospitals have every incentive to raise… Read more »

Stuart Browning
Guest

Ah … yes. Even the kool-aid drinkers are catching on to Mr. Holt’s unfair, misleading (and often ad hominem) attacks on Dr. Herzlinger and others.

Tom Leith
Guest
Tom Leith

I think there is a subtext to HBS’ facination with the Shouldice Institute. Besides the focus Dr. Shouldice had brought to hernia repair surgery, its also because being grandfathered-in and managing to survive in spite of the competition from the state run hospitals, Shouldice is evidently the last “private” hospital in Canada. Last I heard, the government there forbade them to expand.
t