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medpundit |
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Tuesday, November 05, 2002My personal example of how the US government runs medical care is the VA. Chicago's west side VA was still running an Allis Chalmers betatron for radiation therapy 20 years after the unit was obsolete. (I didn't believe a neighbor who was treated on the unit when he described the machine he was treated on, but was at the place a year or so later for a meeting, saw the unit, and was told, "Yea, we finally retired that unit early this year.) I haven't been in a VA hospital in almost fifteen years, so things could have changed, but the one I did some of my clerkships in as a medical student was built right after the Civil War and hadn't changed much in the intervening years. They still had large open wards where twenty to thirty men shared a large room separated only by thin curtains around their beds. (This was in the mid-to late1980's.) They didn't have cardiac step-down units or telemetry floors, and their ICU was very primitive. It was a culture shock to do a rotation at one of the community hospitals and then go to the VA. It was very much as if you had stepped back in time. Things could have changed since then. DB would know. He works at one. UPDATE: DB posted a reply about the current state of the VA system: The VA has some major plusses. They have the best computerized medical record, bar none, in the US. It works in a physician friendly way. When I make rounds this weekend, I can review the labs, the pharmacy orders, the notes and even the X-rays from a single computer. I write my notes there, obviating the search for charts. Our VA has state-of-the-art radiology equipment, but they have difficulty keeping enough technicians to do studies promptly. I believe they tend to understaff the wards, but the ICUs have good staffing ratios. They have improved greatly since my days of training in the 70s. I too trained with open 20 bed wards, today my patients either have private or semiprivate rooms. He mentions some of the problems, too, but overall, it sounds like it has improved since the 1980's. posted by Sydney on 11/05/2002 01:14:00 PM 0 comments 0 Comments: |
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