Better outcomes, lower costs, more-satisfied patients. It's what we all strive for. And it's a goal that continues to elude us.
The technical advances in medicine in this country are remarkable, but our system is fragmented, with inefficiencies that create a barrier to the quality we aspire to. It's a problem that costs all of us—physicians, nurses, administrators, payers and, of course, patients and their families—and one that originates from all areas of medicine.
In primary care, the patient-centered medical home shows promise in improving patient care and producing savings. A similar system can do the same for surgery, where a large percentage of a hospital's costs are incurred, and where managing one complication, such as pneumonia, threatens the patient's outcome and can erase the thin margin from an entire surgical procedure.