By now it's no secret that American healthcare is in the weeds. Some of its problems have been well described -- the funding crisis, the moral and practical challenge of the uninsured, the increasing recognition of medical errors and poor communication with and support of patients and families by their caregivers.
On the inside of the health system, where I and my colleagues are, all these problems are recognized, although some our obscured by the conditions in which we work (cost) and others by our work habits, our culture, and our self-protective rationalizations (few caregivers recognize how poor their communication with patients and families is, for example.) But also from the inside there are many more stress points that the public does not see. Care that sets out to be interdisciplinary and ends up fractured and confused. Reckless use of technology and medicine, often to patient's detriment, chasing the impossible dream of a work-up that takes no time, involves no exercise of judgment (which might leave it open to criticism), and misses nothing. The black hole of documentation which is swallowing giant swathes of time. And so on.
The mission of this blog is simple: we will confront the ways in which we, the American medical community, are broken, the way in which the country itself is broken as regards public health, medicine and law, and what can and is being done about it.