One of the most daunting challenges facing the new U.S. administration
is health care reform. The size of the system, the number of stakeholders,
and ever-rising costs make the problem seem almost intractable. But in
Chaos and Organization in Health Care, two leading physicians offer an
optimistic prognosis. In their frontline work as providers, Thomas Lee
and James Mongan see the inefficiency, the missed opportunities, and the
occasional harm that can result from the current system. The root cause
of these problems, they argue, is chaos in the delivery of care. If the
problem is chaos, the solution is organization, and in this timely and
outspoken book, they offer a plan.

In many ways, this chaos is caused by something good: the dramatic
progress in medical science.the explosion of medical knowledge and
the exponential increase in treatment options. Imposed on a fragmented
system of small practices and individual patients with multiple providers,
progress results in chaos. Lee and Mongan argue that attacking this chaos
is even more important than whether health care is managed by government
or controlled by market forces.

Some providers are already tightly organized, adapting management
principles from business and offering care that is by many measures safer,
better, and less costly. Lee and Mongan propose multiple strategies that
can be adopted nationwide, including electronic medical records and
information systems for sharing knowledge; team-based care, with doctors
and other providers working together; and disease-management programs to
coordinate care for the sickest patients.

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