Dedicated to Change in the Delivery of Health Care


A recent Commonwealth Fund report details the dismal state of the U.S. health care system. (Your local librarian can help you access the website and print the six-page summary for you to read at your convenience.) This report is an embarrassment for U.S. doctors who work very hard for their patients. The fault lies with the leadership of U.S. medicine. U.S. medicine is currently controlled by pharmaceutical manufacturers, government, insurance companies and an inordinate excess of specialists.

According to the report the U.S. ranks last in infant mortality and near the bottom in life expectancy both at birth and at age 60 among industrialized nations. Although inadequate primary care plays a huge role in those statistics, substandard treatment of disease also plays a role.

Doctors use guidelines to treat many conditions. Pneumonia, diabetes, kidney disease, vaccination and heart attack are but a few. Guidelines are formulated by medical and surgical specialty organizations. For example, the American College of Cardiology is responsible for the guidelines used to evaluate and treat heart attack and heart failure. The guidelines for many conditions can be viewed on the government's website:

In order to evaluate the care you are getting by using the guideline clearinghouse you need to know the exact medical term or terms used by your doctor. The actual diagnosis can usually be found on the doctor's bill he sends to Medicare or other insurance company. Ask for a copy of the bill.

Health care philanthropic and educational associations can sometimes be helpful also. However most of these organizations deal with prevention and early detection of disease rather than appropriate treatment.

If you have a chronic disease and are spending a lot of time and money on treatment, there are questions you should be asking your doctor.

To feel better and to save time and money, take a more active part in your health care. Your advocate, and in turn you, can learn more and take control if you know what questions to ask. Taking control is part of the healing process.

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patient centered care

Only patient centered care will lead to quality and cost effective care.