T1-117

In reply to Purley http://cmatalks.blogspot.com/2010/12/t1-86.html

continued....

It is worth considering what you do when experimenting.
You have dependent and independent variables and you measure the unknown against the known.
The mistake made in planning, structuring, delivering, medical health care is the costing focus is on the unpredictable...versus the predictable.
When a patient is institutionalized the stable costing components are on the non-medical components of care. The elements that can be predictably costed, staffed, and improved over time .
It is the funding of the NON-medical components of health that will stabilize the SERVICE environment for the patient/client.

It is the funding of the physician ( not overriding umbrellas clustering private ambitions) that will stabilize the funding environment for the payor. To effect this the physician must adopt a system that enables him/her to perform as a KNOWLEDGE worker ... not simply a prescription writer in someone else's stable.

Face it......... if you remove the physician and the patient form all of these struggles........ the entire remaining structure has no purpose .... and it falls to nothing.

How to do this?
+Seperate primary care totally from the three other levels ( secondary, tertiary, quaternary).
+Fund direct patient/physician interraction at the secondary care level ( hospital setting )
+Let the primary care level learn to stabilize it's function based on HOW they deliver the STABLE components ( non-medical services)
+train the physician to perform in this arena in a "Z" structure under his/her management
+establish a predictable service package directly connecting frontline workers to client/patient

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