Modern Healthcare Delivery, Deliverance or Debacle

Ms. Runouta Patience felt it was time to call her doctor. Her sore throat was just not getting any better. She had an earache, a sinus headache, and was congested. With no appointments available to see Dr. Be Well until late the next day, she decides it's off to QuickFix retail medical clinic to get herself feeling well again. Feeling somewhat better after being treated with decongestants and an antibiotic, a week later she arrives at Dr. Be Well's office for a follow–up visit, where the receptionist hands her a clipboard with pages upon pages of endless forms to complete before seeing the doctor. In addition, she is asked if she wishes to join Dr. Be Well's new accountable care organization–an ACO. What? Wasn't she already his patient? Finally after almost getting writer's cramp, she is taken to an exam room, where in walks Dr. Guess Who, ANP–C, ACNS–BC, DNP. At first, Runouta Patience is disturbed that Dr. Be Well himself is unavailable. But Dr. Guess Who is kind, professional in her demeanor, extremely thorough, and even takes a few minutes to test her understanding of the asthma recommendations that she makes. Leaving the office, Rinaouta Patience writes out a check for her office visit co–payment and upon arriving home downloads an app onto her smartphone that will allow her to send peak airflow rates to her doctor to help manage her asthma. Some weeks later, despite everyone's best efforts, her condition deteriorates sufficiently that she must go to the local emergency room, where she receives a breathing treatment and is admitted to hospital. Expecting to see Dr. Be Well, she is again surprised as in comes young Dr. Hyam Here, who introduces himself as the hospitalist on duty today who will care for her for at least the next forty–eight hours while she is hospitalized.

Through simulated patient scenarios such as these, Dr. Zema introduces many of the relevant milestones that have occurred in healthcare delivery during the past fifty years. Problems currently faced are discussed and potential solutions provided. While everyone ostensibly someday will be a patient, for many, that exposure is intermittent, often skewed, and largely gleaned from the outside looking in. For those who dare, Dr. Zema provides a glimpse of healthcare delivery seen from the inside, looking out, thereby affording readers additional insights whereby they may navigate outside their comfort zone while achieving a broader perspective of the overall healthcare delivery system.

Advance Praise for "Modern Healthcare Delivery…"

"Dr. Zema has authored a most comprehensive tome on our U. S. healthcare delivery system. His observations and citations are cogent and wise, well serving all who wish to gain a greater understanding and appreciation of our current challenges and reasonable/responsible solutions going forward. This is a must read for all interested in a complete awareness of our current healthcare dilemma."

–Thomas E. Price MD
23rd Cabinet Secretary of Health and Human Services (HHS)

"American medicine is desperately in need of change. This brilliant, coherent, and most readable book is a must read for those seeking solutions, both members of the medical profession and the interested lay public."

– Sidney Alexander MD, FACC
Chairman Emeritus, Division of Cardiology
Lahey Hospital and Medical Center

"From the well–chosen book and chapter titles to the researched and documented details, this work is insightful, engaging, balanced, and thought–provoking – an excellent point of departure for those seeking a better understanding of the workings of healthcare and those with interest and influence in healthcare reform."

– Holly Gadd, PhD, RN, APRN, FNP–BC
Dean & Professor, School of Nursing
Southern Adventist University

"No other book encompasses such a comprehensive assessment of our healthcare delivery system, providing history, criticism and potential solutions to this, our greatest domestic endeavor – a valuable read for the lay audience, students and advanced clinical professionals alike. Bravo!"

– William H. Frishman MD, MACP, FACC
Professor of Medicine and Pharmacology
Emeritus Chairman of Medicine
New York Medical College

"Dr. Zema's book highlights many of the changes that have occurred in healthcare that not only have not met their goals, but also have had unintended consequences for patients and clinicians. It is call to action for everyone to actively engage and work together to create a healthcare system that is high quality, equitable, and sustainable."

– Susan Thompson Hingle MD, MACP, FRCP, FAMWA
Prof. of Medicine & Assoc. Dean for Human and Organizational Potential
Department of Medicine, SIU School of Medicine

-- Michael J. Zema MD