The Need for Biomedically and Contextually Sound Care Plans in Complex Patients
Authors: Roger G. Kathol, Mary H. Kathol
Journal: Annals of Internal Medicine (2010)

Letters2 November 2010The Need for Biomedically and Contextually Sound Care Plans in Complex PatientsRoger G. Kathol, MD and Mary H. Kathol, MDRoger G. Kathol, MDFrom Cartesian Solutions, Burnsville, MN 55337.Search for more papers by this author and Mary H. Kathol, MDFrom Cartesian Solutions, Burnsville, MN 55337.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-9-201011020-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Weiner and colleagues (1) provide evidence that error-free treatment plans are rarely created for patients with biomedical and contextual complexity (9%) and are not commonly created for those with contextual (22%) or biomedical (38%) complexity alone. This is not surprising given that primary care physicians are already expected to devote 1.5 times their available patient contact hours to providing preventive, long-term care, and acute medical services (2). Nonetheless, implementing improved skills in error-free or, at least, error-reduced care plans for the complex 1% to 5% of patients who use one quarter to one half of health resources ...References1. Weiner SJ, Schwartz A, Weaver F, Goldberg J, Yudkowsky R, Sharma G, et al. Contextual errors and failures in individualizing patient care: a multicenter study. Ann Intern Med. 2010;153:69-75. [PMID: 20643988] LinkGoogle Scholar2. Bindman AB, Forrest CB, Britt H, Crampton P, Majeed A. Diagnostic scope of and exposure to primary care physicians in Australia, New Zealand, and the United States: cross sectional analysis of results from three national surveys. BMJ. 2007;334:1261. [PMID: 17504790] CrossrefMedlineGoogle Scholar3. Zuvekas SH, Cohen JW. Prescription drugs and the changing concentration of health care expenditures. Health Aff (Millwood). 2007;26:249-57. [PMID: 17211035] CrossrefMedlineGoogle Scholar4. McClellan M, McKethan AN, Lewis JL, Roski J, Fisher ES. A national strategy to put accountable care into practice. Health Aff (Millwood). 2010;29:982-90. [PMID: 20439895] CrossrefMedlineGoogle Scholar5. Kathol RG, Perez R, Cohen JS. The Integrated Case Management Manual: Assisting Complex Patients Regain Physical and Mental Health. New York: Springer; 2010. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Cartesian Solutions, Burnsville, MN 55337.Disclosures: The authors own a health complexity and physical and mental health integration medical management company. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoContextual Errors and Failures in Individualizing Patient Care Saul J. Weiner , Alan Schwartz , Frances Weaver , Julie Goldberg , Rachel Yudkowsky , Gunjan Sharma , Amy Binns-Calvey , Ben Preyss , Marilyn M. Schapira , Stephen D. Persell , Elizabeth Jacobs , and Richard I. Abrams Metrics Cited ByThe Comprehensive Care Plan: A Patient-Centered, Multidisciplinary Communication Tool for Frequently Hospitalized Patients 2 November 2010Volume 153, Issue 9Page: 619-620KeywordsConflicts of interestHealth careHealth care qualityLong-term careMedical servicesNursesPatientsPsychiatry and mental health ePublished: 2 November 2010 Issue Published: 2 November 2010 CopyrightCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...