cover image From Chaos to Care: The Promise of Team-Based Medicine

From Chaos to Care: The Promise of Team-Based Medicine

David Lawrence. Da Capo Press, $25 (208pp) ISBN 978-0-7382-0753-7

Written by the former CEO of the nonprofit health-care organization Kaiser Permanente, this book makes the case for a humane version of managed care that operates under a collaborative model. Lawrence describes how, despite the goodwill of medical practitioners, his terminally ill father suffered needlessly because the treatment he received under Medicare was not coordinated by a medical team. Lawrence also contrasts the care Rebecca (a fictional child with asthma) received when she was treated by her solo pediatrician (also fictional) with the more integrative and effective care provided after her family's insurance was changed to a health-care organization. Believing that the age of the individual practitioner is over, Lawrence emphasizes team-based delivery of medical services within managed care and argues for the necessity of making critical patient information easily available to doctors and care-providers. Collaborative care for chronic illnesses makes sense, he argues, since staff access to technology to facilitate referrals and decisions about treatment can be delivered under the umbrella of health organizations. He also identifies several HMOs that, according to him, are models of the team-based approach. However, his examples of corporate managers such as Jack Welch, former CEO at GE, as an inspiration to health-care organizations that are trying to hold down costs is ultimately unconvincing.