proper medical care of the sickest patient of all: j. deane waldman, md mba university of new...
TRANSCRIPT
Proper Medical Care of theProper Medical Care of the
SickestSickest Patient of All: Patient of All:
J. Deane Waldman, MD MBA University of New Mexico:
• Health Sciences Center &• Anderson Graduate Schools of Mgmt
University ofNew Mexico
HealthcareHealthcare
University ofNew Mexico
Principles of Good Medical Practice
Healthcare Dx &Healthcare Dx & R Rxx
JD Waldman, MD MBAJD Waldman, MD MBA
1. Gather data: Obj. & Subj; Present (pt) & past (lit.)
2. Make etiologic diagnosis
3. Evidence-based decision making (logic ≠ sufficient)
4. Treat causes, not symptoms
5. Measures all outcomes, esp. desired & unintended
6. Partner with patient
7. Adjust treatment plan PRN
University ofNew Mexico
Diagnostic ToolsDiagnostic Tools
• History• Physical exam• X-rays• Lab studies• Review of lit
• Rx partnership
• Provocative tests• Therapeutic trials
For Sick Person For Sick System
• Value Chains• C. A. P. A.• Queueing theory• Systems thinking • Learning curves• Constraints analysis• Cultural survey• 5 Forces analysis• Managerial acc’ting• Lean management
Healthcare Dx &Healthcare Dx & R Rxx
JD Waldman, MD MBAJD Waldman, MD MBA
• BCG Matrix• Checklists• Compet Profiles• CGE / CQI / TQM• Grainger causality• Heijunka• Markov model• Network analysis• Simone’s maxims• Venn diagrams
IllustrationsIllustrationsHealthcare Dx &Healthcare Dx & R Rxx
JD Waldman, MD MBAJD Waldman, MD MBA
Etiologic Diagnosis:Disconnection
Healthcare Dx &Healthcare Dx & R Rxx
JD Waldman, MD MBAJD Waldman, MD MBA
What is disconnected from what?We….are disconnected from……our money.
Measured outcomes…disconnected…desired ones.
Decisions….are disconnected from……outcomes.
Behaviors….are disconnected from……incentives.
WE…disconnected…consensus principles.
The cure is therefore…RECONNECTION.
Healthcare Dx &Healthcare Dx & R Rxx
JD Waldman, MD MBAJD Waldman, MD MBADialogue is thefirst step
Leading toReconnection.
‘Enfranchises’Spanish-speaking
Americans.