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General interest items edited by Janice Flahiff

[Reblog] Article about a doctor who shunned research to serve under- and uninsured

I do admire this physician’s initiative and perseverance in finding financial resources to serve the costliest patients in Camden.

From the  20th November blog item at -Jot Sheet –  “I’d just sit there and play with the data for hours.”

I’m re-reading an essential healthcare article by Atul Gawande, published in the New Yorker in January, 2011. **I can hardly believe that was only about three years ago. It made a huge impression on me. The article begins with a profile of Dr. Jeffrey Brenner, whose explanation of his work to identify trends in emergency room use in Camden is the title of this post.

As a medical student at Robert Wood Johnson Medical School, in Piscataway, he had planned to become a neuroscientist. But he volunteered once a week in a free primary-care clinic for poor immigrants, and he found the work there more challenging than anything he was doing in the laboratory. The guy studying neuronal stem cells soon became the guy studying Spanish and training to become one of the few family physicians in his class. Once he completed his residency, in 1998, he joined the staff of a family-medicine practice in Camden. It was in a cheaply constructed, boxlike, one-story building on a desolate street of bars, car-repair shops, and empty lots. But he was young and eager to recapture the sense of purpose he’d felt volunteering at the clinic during medical school.

I like to read this article every year or so. I appreciate the appeal of untangling complicated problems and balancing your work between data-driven analytics and the expertise of real, live people.

“For all the stupid, expensive, predictive-modelling software that the big venders sell,” he says, “you just ask the doctors, ‘Who are your most difficult patients?,’ and they can identify them.”

A lot of what Brenner had to do, though, went beyond the usual doctor stuff.

Here I would argue that nurses are trained for the type of work Brenner describes. Yes, there are special doctors who are turned on by this kind of work, but far more common are nurses who take a holistic view of their patients’ lives.

If it were up to him, he’d recruit a whole staff of primary-care doctors and nurses and social workers, based right in the neighborhoods where the costliest patients lived. With the tens of millions of dollars in hospital bills they could save, he’d pay the staff double to serve as Camden’s élite medical force and to rescue the city’s health-care system.

But that’s not how the health-insurance system is built. So he applied for small grants from philanthropies like the Robert Wood Johnson Foundation and the Merck Foundation. The money allowed him to ramp up his data system and hire a few people, like the nurse practitioner and the social worker who had helped him with Hendricks. He had some desk space at Cooper Hospital, and he turned it over to what he named the Camden Coalition of Healthcare Providers.

There is so, so much more good stuff in this piece. It’s getting to the point where I am just copying and pasting, any it’s better to simply read the whole thing.

** THE HOT SPOTTERS – Can we lower medical costs by giving the neediest patients better care?
New Yorker, January 2011

 

November 22, 2013 Posted by | health care | , , , , , | Leave a comment

   

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