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http://www.ted.com/index.php/talks/barry_schwartz_on_our_loss_of_wisdom.htmlI encourage all the recipients to watch the video, one could replace janitor with Physician to make it more poignant.

Maybe we can regain some control of our own lives if we become wiser and encourage/enable others to do the same, particularly hospital administrators, insurance companies and other Physicians.Just today a " Case Manager " called me to inform me that my 79 y/o patient with MRI confirmed L4-5 HNP in pain, unable to stand did not meet admission criteria because of lack of " Acuity of Care " . He is also mildly demented, diabetic, incontinent and his 77 y/o female companion/roommate is somewhat frail herself, unable to assist him if he falls down. Of course, if I order IV therapy that takes care of some of the issues for the hospital administration... Is this a cost effective way to manage this patient? I don't think so! I will not burden the reader with more details, I am sure all of us have a number of cases like this one.

Would a " Health Care Czar " be able to change the schizoid management system?Could we start documenting these instances and forward the issues (complying with HIPPA) to CMS, and lawmakers? Would anyone pay attention?

Any suggestions?-- Pedro Ballester, M.D.Warren, OH

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