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The United States administration is facing a daunting challenge in its quest to reform healthcare in the nation. The challenge is made even more intractable by the required size of the system, the continuous rise in costs as well as the involvement of multiple stakeholders. In the book, Chaos and Organization in Health Care, the authors, who are leading physicians in the U.S., provide an optimistic diagnosis of the problem. The authors are well aware of the various problems in the health care such as the inefficiencies, opportunities missed, as well as the possibility of occasional harm if the current system is upheld. According to theses physicians, health care in the United States is in chaos due to the manner in which it is offered in the current system. Consequently, they offer a workable solution to the system- organization. They argue that health care organization can abolish the current chaos in health care delivery. From the perspective of the authors, the chaos is as a result of positive causes. They argue that the United States has undergone dramatic advancement in medical science whereby many treatment options as well as medical knowledge have been discovered. According to the authors, if such knowledge and treatment options are applied in the fragmented system that exists at the moment, there is bound to be chaos (Anderson & Burckhardt, 1999). As such, the most important thing needed is to attack and eliminate the chaos. The authors therefore offer quality arguments on reforming the U.S health care system without having to involve the government extensively.
Health care organization is at the core of the success of the system. According to the two physicians, some providers have already adopted organization of their systems and are now benefiting greatly. In fact, most of these health care providers have adopted principles of management from business. As a result, they have been able to offer a form of health care that is not only safe and better than those available but also at the minimum cost possible. Mongan and Lee make multiple propositions on various nationwide strategies such as maintenance of medical records electronically as well as the development of information systems to facilitate knowledge sharing (Barry & Fennell, 1995). Additionally, they propose for the creation of a health care based on team work approach whereby health care providers and doctors work together for a common goal. Moreover, the authors are of the view that there is need for programs aimed at disease management to be created and purely be devoted on the provision and coordination of care for the patients who are very sick.
Generally, health care problems are created by the main players in the provision programs. In fact, the doctors and health care providers are to blame to a greater extent for the continued deterioration of the health care in the United States. In particular, the fact that most of the doctors practicing medicine in the United States have less knowledge of finance and other management skills has rendered health care provision a major crisis. Dr. Mongan and Dr. Lee believe that change of leadership strategies and adoption of business management principles in the provision health care will transform the current system. There is no doubt that the progress made in medicine has been the major cause of increasing costs in health care provision. In fact, the U.S health care sector has undergone massive progression in areas such as discovery of new drugs, new devices as well as new tests and treatment plans. The new innovations in medicine are particularly expensive and complex (Lee, 2010). The consequent results have been intensified specialization among doctors. The specialization requires patients suffering complex conditions to see many doctors spread across diverse institutions.
The explosion of medical practice is regarded positive due to the fact that the new innovations have saved several lives. However, the intensified knowledge is being carried out with the wrong health care system. The fragmented and chaotic health care system presently available is simply incompatible with the explosion in medical practice. The intense knowledge and spread of medical technology has somewhat thrown matters into disarray by reducing the communication and coordination of treatment procedures among doctors. While the explosion of medical knowledge and technology is very important for successful treatments to be undertaken, there is equally a need for good leadership in health care provision. According to the two doctors, there is a need to incorporate leadership skills among medical practitioners are every level. They agree that levels of work performance may differ across diverse settings; however, responsibilities of leadership ought to remain similar.
There are three essential points put across by the authors that every health care leader needs to fully understand. To start with, the two doctors suggest that it is imperative for every medical practitioner to consider the outcome of his/her performance. In fact, the most important thing is not the number of procedures done or the number of number of patients seen; rather, it is the quality of the service provided. The quality of a health care is measured by the results and outcome of the procedure. Nevertheless, medical practice has had an inherent controversy when it comes to performance comparison. The authors argue that the wellness of the patients is the most important thing to consider in all healthcare procedures (Lee, 2010). According to them, all medical practitioners need to ask themselves honest questions regarding the care they provide to patients. For instance, it is important for practitioners to determine the extent to which patients’ needs are met by the care given to them. Similarly, health care givers need to know the survival rate of the patients under their care. Moreover, it is imperative for the health care providers to know the rate at which patients get infections as well as other forms of complications.
Secondly, the authors emphasize on the importance of value in health care programs. In fact, they defend the word value by arguing that it does not usually connote the reduction of cost. In stead, they base their explanation for value in health care from Michael Porter’s perspective. Therefore, the authors define value as the act of obtaining the best outcome in the most efficient way possible. Actually, the explanation is not meant to be determined in numerical terms as is the case in other areas. Rather, it is supposed to facilitate meaningful comparisons to be done by health care providers in diverse practices (Orzano et al, 2008). The most important outcome for the emphasis on value in health care provision is the increased call for improvements in health care provision. Moreover, the comparisons facilitate for the exchange of knowledge as well as increase the level of competition among health care providers.
The third point by the authors is perhaps the backbone of reforms in health care provision. According to the authors, if improvements are to be experienced in health care provision and particularly in the attainment of desired outcomes, teamwork is critical. The authors admit that hospitals and clinicians often have minimal control in determining the fate that befalls their patients. Therefore, superior coordination is of paramount importance in organizations providing health care. Similarly, several factors such as information sharing, coordination and interdisciplinary teamwork are essential for the eradication of chaos in health care provision and focus towards massive improvement. The authors also articulate certain measures that are helpful in improving the quality of health care provided by various providers. For instance, they encourage providers to embrace performance measurement by outsiders. They readily admit that measurement of performance by outsiders often seem difficult. However, such a move is highly helpful as it inject new leadership in the organization. Embracing new leaders in health care provision enables a focus on outcome as coordination of all stakeholders.
The authors identify several factors that are particularly imperative for the restoration of order and organization in the provision of health care in the United States. Firstly, they emphasize on the importance of articulating the values and vision of health care programs. According to them, the process of reorganization requires articulate goals and rationale to drive change. The fact that change is often a hard undertaking in virtually all areas makes it even much harder to implement it in medical practice where maintenance of status quo is at the helm of the practice. According to the view of many medical practitioners, change is a very risky thing to undertake and therefore the sustenance of the traditional practices should be encouraged (Orzano et al, 2008). Nevertheless, vision and value are very important aspects that need to be observed by all leaders in health care provision so as to enhance resolution and understanding. The two physicians believe that effective vision can motivate people to embrace change as the means towards the realization of the set goals.
Secondly, it is important for leaders in health care provision undertake measures aimed at performance organization. In fact, it should be articulated with such strong radicalism than any other activity. The two physicians dismiss the era of overlooking quality by substituting it for profitability and volume of services (Lee, 2010). Surprisingly, the traditional medicine world mainly centers on the activities of the doctors as opposed to the needs of the patients. For instance, a conventional hospital is organized in terms of various departments each specializing on a particular area. Worse still, the departments often manage their activities including bills such as insurance. In the process, patients get confused by the various bills from the diverse departments. This is the nature of chaos that needs serious attention in health care.
Thirdly, there is need for health care providers to develop an effective system of measurement. The system is mainly meant to measure institutional performance in a harmonious manner. The system so developed needs to be in such a way as to provide similar measures to all members. In fact, the system of measurement should be in the same language to avoid favoring some members. The importance of adopting similar measures of performance for all organizational members is particularly seen in the data obtained from across all members. With similarities in data being registered in the organization, it is not only reliable but also appropriate for best practices to be standardized. It is also imperative to adopt a system of measurement with appropriate metrics to detail outcomes and costs in all episodes that take place. Such a system no doubt provides an efficient system to eliminate chaos in favor of organization and order.
Perhaps the importance of developing effective teams in health care provision can not be overemphasized. In most cases, physicians to work in teams as they often consider themselves heroic healers. All types of health care providers require team work if any success is to be realized. It is imperative for health care coordinators to coordinate care. In this case, doctors are expected to not only be team leaders but also players in the team. When physicians are involved in the actual work of giving care as well as leading other members, there is bound to be success. The importance attached to team building is especially attached to the attainment of competency by all the members involved. The two physicians argue that there is a need for doctors to change their motives for team building. Additionally, there is need to improve on the processes of health care provision. Due to the continued complexity of health care procedures, practitioners need to continuously work towards the attainment of efficiency and reduction of wastes and errors.
Ultimately, the soundness of the arguments provided by the two physicians is unparalleled. Overcoming chaos in health care provision is a crucial for the realization of order in health care provision. The doctors depict utmost experience and competence in their skill. In fact, their arguments are timely in that they seek to offer a solution to the intensifying chaos in the provision of health care. The ideas are clear and applicable in reducing cost of health care as well as offering quality outcomes to patients.