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June 1997
Volume 61 |
Number 6
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TO THE MEMBERSHIP
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| A Miss Is as Good
as a Mile |
The huge transatlantic 747, complete with 452 passengers, approached
the fog-bound Paris airport and, after circling twice, began its
approach to runway G-7. Passengers gazed from the windows but
were met by thick fog, no land marks were visible yet, when suddenly
following a slight jolt, they were deposited safely on the runway.
The airplane came to a halt at the terminal gate and, upon emerging
from the cockpit, a senior flight attendant accepted the applause
from the grateful passengers for their safe arrival.
It seems that the airline industry had successfully emulated
its medical colleagues who had moved from a "cottage industry"
to corporate giant. Re-engineering has led to the concept of cross-training
personnel to provide efficiency at a reduced cost. As physicians
are displaced by nurse "specialists," the void is filled
by less skilled personnel "trained" to provide nursing
functions (i.e., I.V. teams, ECG teams, etc.) ad infinitum.
As in any game, there are winners and there are losers. The losers
are the critically ill whose care will be relegated over time
to a cadre of decreasingly skilled, less knowledgeable "health
care providers." Economics increasingly will drive health
care in an effort to reward the winners, namely the shareholders
and CEOs of the "for profit" corporations.
It has been postulated that the term "re-engineering"
is a synonym for the "Consultants' Re-employment Act."
As such, it has been successful beyond all expectations.
Erwin Lear, M.D.
Editor
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