Peeking Behind the Curtain: A View From Inside a Hospital
What things at Maimonides might be models for other hospitals?
Maimonides has more than 30 [employees called patient representatives]. Those were the people who'd provide those extra touches; they'd stop and have a conversation or settle a patient's anxiety so he wouldn't later be buzzing the nurse 50 times. Doctors and nurses would get annoyed with them, but they were there to be patient advocates. Of course, none of that was reimbursed by insurance!
Did your year at Maimonides leave you more optimistic or pessimistic?
A little of both. The people who work there aren't getting what they used to get—respect. Before, no matter how hard or difficult it was, you could feel you were doing a special service. Now they feel very beleaguered, and they don't get that gratitude. But I was impressed how hard they were trying and how the vast majority of people there, down to the people cleaning the floors, seemed to have some kind of a sense of mission. Something about this work still draws very bright people. But how long will that continue?
Any radical ideas for addressing healthcare shortages?
The payment structure is set up so that primary-care medicine is an absolute financial loss, yet those are the doctors who can give most people what they want. I think medical education should be more like the military or police training, because right now people don't want to go into it because they don't want to be getting out of debt when they're 42.
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