The American Health Care Paradox by Elizabeth H. Bradley

The American Health Care Paradox by Elizabeth H. Bradley

Author:Elizabeth H. Bradley [Bradley, Elizabeth H.; Taylor, Lauren A.; Fineberg, Harvey V.]
Language: eng
Format: epub
ISBN: 9781610392105
Publisher: PublicAffairs


According to LA PALESTRA’s credo, this control, or sustainable functioning, can only be attained by addressing all aspects of clients’ lives. Manocchia has assembled a staff representing an array of disciplines, who work in concert to tackle each complex challenge. A typical team includes representatives from internal medicine, orthopedics, nutrition, psychology, clinical social work, physical therapy, chiropractic care, cardiology, acupuncture, and massage therapy. The staff is affiliated with many of the most reputable acute-care health facilities in New York City, including Mount Sinai Hospital, New York Hospital/Weill Cornell Medical Center, the Hospital for Special Surgery, Beth Israel Hospital, as well as the New School.

Manocchia contrasts his initial vision with that of the original HMOs to explain his model of care. While HMOs ultimately manage only the costs of care, Manocchia was emphatic: “I want to literally manage people’s care.”11 Many clients look to him for advice on how to decipher pain from injury, which procedure to pursue and which to avoid, which doctors to seek out, and which medicines to take. While we were with him, Manocchia fielded an e-mail from a client who asked how he should proceed in navigating the health care system on behalf of his elderly mother, who had just received disconcerting biopsy results from a suspected cancer lump. In light of such a broad-based mandate, Manocchia resists people’s efforts to put him into the box of being a “trainer.” When we asked what he would call his role, he did not miss a beat: “A caregiver.” Then he recanted, “I don’t know. I wouldn’t put myself in a box.”

The LA PALESTRA team takes an integrative approach to relieving clients’ aches and pains. For them, intervening solely at the site of pain through traditional medical means may address immediate symptoms but in many cases is unlikely to resolve the actual cause. In fact, by not addressing the underlying issues, the traditional approach may predispose people to further injury, which can result in still more costly care. In Manocchia’s view, pain is often the body’s way of signaling that something foundational is not working:

Pain is not the problem. The problem is the problem. Pain is the body’s way of letting you know there is a problem.12



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