America’s health care delivery system is in disarray. Politicians on both sides of the aisle believe that they have the answer. But, fixing this problem does not lend itself to a political solution. Ultimately a meaningful solution is one that only physicians can offer. This is as it should be, but it is not happening. This book is my attempt to recast my journey in medicine as one that I believe has isolated the problem and found a solution. It begins with my observations in medical school, my fledgling attempt to be a good doctor, and ultimately my discovery of the problem and its solution. There is no question but we have the most marvelous and sophisticated health care system in the world, but our patient outcomes leave much to be desired when compared with those of other industrialized countries. Our rising health care expenditures, the asymmetry in the delivery of our health care system, and the calcified ideology of both the political right and left are sources of concern. I have attempted to share my insight with our citizenry in hopes that a concerted voice will be forthcoming demanding those changes from the health care industry that it and the government have been unable to accomplish. Without these changes a political solution will win out and mediocrity will replace quality. Time is short. Both political parties are sparring in an effort to imprint their ideology on a roadmap ostensibly designed to fix the problem, but one that does not come close to dealing with the salient issue. The strength inherent in a unified voice of the people will galvanize the industry and my hope is that this book will serve as a stimulus.
Dr. James Hansen’s vision and insight regarding the nature of the health care crisis evolved from positions of medical staff leadership, teaching, participating in [the governance process, and developing a free clinic. These positions, together with his 35 years as a consulting physician, presented him with the opportunity to view physician behavior and its impact both on patients and upon health care in general. These observations crystallized his conclusion that the essence of successful health care springs from the physician-patient relationship. Dr. Hansen received his undergraduate degree from Vanderbilt University. He then attended the University of Southern California School of Medicine where he received his MD in 1965. His post graduate training in internal medicine occupied the next four years at the Los Angeles County-USC Medical Center. After a three year stint in the Army he returned to Wadsworth VA-UCLA for a fellowship in gastroenterology. Dr. Hansen is certified by the American Board of Internal Medicine, the American Board of Gastroenterology, a Fellow of the American College of Physicians, and a Clinical Professor of Internal Medicine at the University of California, Davis School of Medicine. He has been in private practice since 1973. He was appointed to the Mercy Healthcare Board of Trust in 1988, serving in that capacity for three years. He served as chief-of-staff for both American River Hospital and Mercy San Juan Hospital from 1990-1993 and was actively engaged in consolidating the medical. staffs of those two hospitals which merged in 1993. He was the chairman of the Physician Leadership Group for the 5-hospital Mercy Healthcare Sacramento system from 1995-1998 during a period of hospital redesign. Dr. Hansen was actively involved in teaching at UC Davis, School of Medicine for nearly 20 years as a voluntary clinical faculty person. In 1994 he helped develop a free clinic in Sacramento and became its medical director until moving to Maui in 2001. Dr. Hansen has been in the private practice of gastroenterology in Maui since 2001. Dr. Hansen’s unique perspective as a practicing physician, physician leader, and medical educator provides the perspective and passion for his quest of the root cause and cure of the health care crisis. This book offers a solution for the health care crisis, which focuses on the need for a grass level approach and revolution led by the citizenry.