Medicine of the Future in America

The Paradox of High-Tech Health Care: Conclusion

These are but a few of the possible solutions to this growing problem. Nursing administration at the highest levels in this country should be deeply involved in helping medical and surgical specialties solve these critical care problems. The nursing profession will be in a defensive position on this issue if it does not take a positive, creative stand on implementing programs to increase numbers of qualified nurse intensivists. A multidisciplinary approach to seek better job satisfaction for critical care personnel will be important steps toward the improvement of the delivery of high-technology services. If these or similar programs are not instituted, the many tens of thousands of patients requiring high-technology medical and surgical services will be poorly served. Here

Treating and rehabilitating the very complex high-tech health care patients in cardiac surgery, organ transplantation, trauma, and other high-tech health care areas is the ultimate gratification of all of us who work in this field. I think the future of high-tech health care over the next decade is fairly clear. The ethical dilemmas of medicine will increase, and more elderly patients will require maximal care. We need to prepare our hospitals with data to fall back on and prognosticate. We will be continually involved with the people who pay the cost of medical care to reduce this cost. Physicians, surgeons, nurses, and other health care specialists will have to become actively involved in the process to reduce cost while maintaining quality of care, or we will be totally and irrevocably bypassed by third-party payers, the federal government, and the public. Malpractice insurance and the contingency fee system is an insidious and very serious cost-raising device in this country and must be limited for reductions in overall healthcare costs. Finally, we are facing a critical shortage of intensive care unit nurses and other paramedical personnel. If the nursing profession is to maintain its leadership role in the care of the intensely ill patient, it must adapt, change, evolve, and restructure its thinking to provide appropriate levels of woman/manpower. Physicians in these areas adopt a more collaborative attitude toward nurse professionals, so that we may both provide the public the very best in high-technology medicine and surgery.

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