Cover image for From chaos to care : the promise of team-based medicine
From chaos to care : the promise of team-based medicine
Lawrence, David, 1940-
Personal Author:
Publication Information:
Cambridge, MA : Perseus Pub., 2002.
Physical Description:
xx, 185 pages ; 24 cm
General Note:
Includes index.
Subject Term:
Format :


Call Number
Material Type
Home Location
Item Holds
R729.5.H4 L38 2002 Adult Non-Fiction Central Closed Stacks

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Dr. David Lawrence has had a long and distinguished career in medicine, crowned by his current role as CEO and Chairman of Kaiser Permanente, the largest non-profit healthcare system in the world and the leader in integrated medical care. A sophisticated, team-based approach that draws on the strengths of the healthcare organization as well as on community resources, integrated care is a most cost-efficient healthcare business model. It also gives patients that all-important sense of control over their conditions and provides the kind of care they can navigate and trust: personal, safe, cohesive, and effective.In From Chaos to Care, Dr. Lawrence shares his unique medical and leadership perspective, outlining a blueprint for lasting and healthy change for the business of health care. Rich with stories of the ways in which integrated, team-based care succeeds on both the human and organizational fronts, this book is an urgent manifesto for the implementation of high-quality and cost-effective health care for all. For doctors and insurers, specialists and healthcare administrators alike, From Chaos to Care illuminates the path to the future of American medical care.

Reviews 3

Booklist Review

In less than 200 pages of text, Lawrence, Kaiser-Permanente's CEO and chairman for 10 years, provides much valuable information and many suggestions for improvement that medical-care team members as well as patients and their families could take to heart. He first describes the confusion surrounding his father's final illnesses and death, which involved major problems of communication by hospital and nursing home medical-care teams and failure to involve patient and family in decisions concerning feeding tubes and other, similar instruments. In contrast, the major portion of the book describes the case of a hypothetical child with asthma as recounted by her mother. Lawrence graphically contrasts the child's first asthma therapy, provided by a pediatrician in solo practice, and that given by a broadly based medical support team that, as envisioned by a recently published U.S. Institute of Medicine report, includes dietitians, breathing specialists, and others besides doctors and nurses. Child and mother, initially vigorously opposed to the support-team approach, are gradually won over by the clinical results. --William Beatty

Publisher's Weekly Review

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. (Nov.) (c) Copyright PWxyz, LLC. All rights reserved

Library Journal Review

Imagine a team of medical professionals, including doctors, health educators, nurse practitioners, pharmacists, and therapists, that is interested in and knowledgeable about your personal medical history. These experts have access to the latest research and technology, as well as your complete medical and pharmacological history, and communicate regularly with one another and are open to your input to form a treatment plan. Sound too good to be true? Lawrence, a physician and the longtime CEO of the large, not-for-profit HMO Kaiser Permanente, contends that team-based medical care not only works well but can also provide better treatment than traditional single practitioners. Lawrence acknowledges that there are many challenges to achieving the goal of integrated, team-based care, but he offers numerous real-life examples of organizations heading in this direction. Although the lack of bibliographical references may frustrate the scholar, this brief but persuasive book is highly recommended for public libraries and health science collections.-Tina Neville, Univ. of South Florida at St. Petersburg Lib. (c) Copyright 2010. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

Table of Contents

A Note to the Readerp. ix
Introductionp. xiii
1 Rebecca, Ages Two to Six: The Chaotic Years with Dr. Landersp. 1
2 The Changing Face of Medicinep. 11
3 Adam Landers, M.D.: The Solo Practitionerp. 37
4 Rebecca, Ages Six to Nine: Asthma Care with a Teamp. 51
5 Care That Works: Beacons for the Futurep. 67
6 Outside the Walls: Some Lessons from Other Industriesp. 101
7 Putting It Togetherp. 131
8 Getting Therep. 151
9 Reflections: Rebecca's Mother Looks Backp. 163
Acknowledgmentsp. 171
Indexp. 175