Most [doctors] are in practices with five or fewer other physicians. They keep their records
on paper in longhand. When they need to consult a colleague, they reach for the telephone.
They bill for each visit. They have little idea about how their skills compare to those of fellow
practitioners, nor do most know what their patients really think about the care they give.
The new health-care law aims to change most of that.
Fifty years from now, it is likely that almost all doctors will be members of teams that include
case managers, social workers, dietitians, telephone counselors, data crunchers, guideline instructors,
performance evaluators and external reviewers. They will be parts of organizations (which either employ
them or contract with them) that are responsible for patients in and out of the hospital, in sickness and
in health, over decades.
Figures that do not include environmental damage and human concerns
are ridiculous. We produce oil for human concerns and the fact that
the oil spill may destroy livelihoods and beaches and wetlands and
coastal industries as well as threaten food supplies is substantially
more important than any production statistics. Of course, we produce
more oil than we spill. Big deal.
