Optimum versus Maximum
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- 作者：Prof. J. Schmidli FEBVS ; M. K. Widmer
- 关键词：SchlüsselwörterQualitätsnachweis ; Gefäßmedizin ; Leistungserbringung ; Kostendruck ; Patient ; Arzt ; Beziehung
- 刊名：Gef?sschirurgie
- 出版年：2016
- 出版时间：September 2016
- 年：2016
- 卷：21
- 期：5
- 页码：278-284
- 全文大小：442 KB
- 刊物主题：Vascular Surgery;
- 出版者：Springer Berlin Heidelberg
- ISSN：1434-3932
- 卷排序：21
文摘
In times of ongoing economy-driven attempts to improve the efficiency of hospitals and departments, the question of optimum versus maximum is justified. The new strategy does not always take the patient into consideration. The doctor-patient relationship is suffering. Success should not only be measured by an increase in the number of patients. Instead, the long-term quality of treatment should be measured and unnecessary readmissions must be avoided. Whilst vascular surgery in the UK and in Scandinavia is centralized, virtually anyone can practice in Germany or in Switzerland, as long as it is financially worthwhile. In a fragmented vascular medicine care various players try to enforce only those treatment concepts for which they are trained. Alternative treatment options, such as open vascular surgery, are barely mentioned because these methods and their results are hardly known; however, patients and doctors still need to know the treatment risks and the appropriateness should always be questioned. Especially in frail patients, limiting aggressive forms of treatment might be a sensible option. Besides technical skills, which can increasingly be trained nowadays by simulation, it is of upmost importance that decisions on how to treat the patient should be made cautiously and carefully in order to find the best solution for the patient and a good balance between optimum and maximum.