Holistic Approach To Hospital ManagementThe generalist comes first - Holistic handling of specialists and their specialities - Optimal labour organisation - Clinic security
(Ganzheitliches Klinikmanagement: Primat des Allgemeinarztes - Umgang mit Spezialisten - optimale Arbeitsabläufe - Krankenhaus "Security")
This article is about professional organisation, philosophy, and procedures for doctor´s work in the hospital. Future medical work needs holistic and psychosomatic approach as well as a continuous evaluation of efficiency and success. Every in-patient should get a generalistic doctor as a main partner in the hospital similar to the general practitioner for the out-patient.
|It is not only in medicine that wholeness is said to be lost - but it is in practice medicine where it is growing again!Without being noticed by the broad public, new ways of holistic medicine are being developed, equally competitive in technology and psychology. Mostly younger practitione(e)rs increasingly engage into integrating traditional healing techniques and up-to-date high tech medicine within their everyday practice work. This article is about how to achieve this integration in a hospital setting. |
The generalist comes first
Just as in ambulatory medicine a generalist supported by specialists will be cheaper and more effective also in a hospital setting than a lot of separated specialists could be. High tech medicine needs a general practitioner able to
accompany the patient as a whole person throughout his lifetime. Otherwise we simply get a repairing medicine without any long-term success.
For example, a noticeable amount of minor traumata and injuries can be a pathognomonic sign of alcoholism - the learned surgeon knows this of course. But no use is being made of this knowledge in the hectic state of the surgical practice or the casualty ward. If the injured alcoholic would see his family doctor for first stage treatment and later would see him for postoperative treatment or taking out the stitches - instead of primarily and only looking up the specialist - the practitioner would get a chance of seeing and maybe further exploring the background of the injuries. Besides improving
psychosocial care this might save money - that`s why the new German Health Saving Legislation favours limited access to medical specialists.
In theory German Health Insurances always wanted the patient to be recommended to see the specialist by the family doctor. But the general practitioners
| never had the self-confidence|
and the competence to insist on this. They could not even explain to the specialists or to their patients why the out-patients should see the generalist first. Signing hundreds of reference certificates (Überweisungsscheine) without seeing
the patients ist still current work for quite a number of family doctors. The well-informed out-patient of today thinks he knows best which specialist he should see and saves
time by not going to his family doctor.
Clinic and hospital always should and want to set standards, but they never had someone like a general practitioner or a family doctor planning and integrating all therapeutic activities. Many a hospital department is just the long arm of a
specialist´s practice - or vice versa -, abusing the G.P. as a cheap and ill-honoured labourer for writing out prescriptions. If a hospital were to see itself as a service unit for the family doctor, we could develop a personal plan for every
in-patient integrating every possibly useful therapeutic approach. Every patient admitted to the hospital could be examined in a transit station to find out how much specialized diagnostics or therapy and how much general medicine or natural healing he needs. The severely ill heart patient in a state short of developing pulmonary oedema will of course go the cardiological ward, but getting additional
acupuncture treatment for his nervous state may normalize his arrythmia - although the latter was not grave in cardiological terms.
The multimorbid adipose instead would be examined cardiologically too, but would be treated on a ward for biological healing where together with the family doctor his general lifestyle as well as his marital problems were to be worked on. At the same time his chronic constipation was treated
with a belly massage and the blood flow stimulated by autohaemotherapy with ozone
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