Future Health Care
The accessibility of facilities in space and time can affect the quality of services. Looking at a health-care system that benefits from these advantages, it seems like such a health-care system is greatly superior to anything available today. The trick is to make the maximum effective use of health facilities for the city as a whole. These include such medical facilities such as:
1. Intensive Care
2. Acute Care
3. Extended Care
4. Neighbourhood Health Centers
5. Blood Banks
Professional personnel include nurses, physicians,
and the paramedics. In the future, health care may become a right rather than
a privilege. Its goals are to make a high standard of health care equally accessible,
available, and acceptable to all citizens.
Going to the Doctor in a Today's City
We start off by giving an imaginary example of what a run-down mother may go through to get medical help in today's city. She begins by calling her doctor's office for an appointment. Since there is no emergency, a date is established for a visit some three weeks later. The time selected is one that is convenient for the doctor. It is not in the evening when someone can take care of the mother's three children, not on Wednesday afternoons when the doctors play golf and discuss mutual investment plans, and definitely not on the weekend. Her doctor, in whom the mother has abundant confidence, happens to be a specialist in gastrointestinal disorders. His time is valuable, and, as noted, is hard to visit. In fact, she considers herself lucky to have arranged to see the doctor so soon. She next arranges for a baby sitter.
Unfortunately, on the day of the appointment, the
baby sitter cannot make it, and so the mother has to take the children with
her. The parking lot is full, and she has to park three blocks away and they
all walk to the clinic. The waiting room is full, and the mother has to wait
an hour before seeing him. All of this would not be so bad except that there
is no place for the kids to sit. They wander around picking up the latest virus
from the other patients. Finally, the doctor sees her and tells her she is run
down. He suggests she get more rest and take a high-potency vitamin. Mother
and children go next to the pharmacy.. She has to wait in line to get her prescription.
The kids by this time are quarrelling, the evening traffic jam has started,
and supper is late.
Routine Medical Service In the Future Cities
Each residence would be equipped with a view phone. The citizen desiring medical advice would call his neighbourhood health center. The sector clinic is always open with a full complement of personal available around the clock. Usually a paramedic, familiar with the patient's medical history, would discuss the illness with the patient whom he sees on the view phone, in "living colour". If the patient's medical record is needed, the Paramedics could immediately have it retrieved from a central computer data bank and displayed on his monitor beside him. The medical record would contain a complete medical history of the patient, immunizations, allergies, illness, and medications. It would also contain a computer analysis of trends in the patient's medical history. If the patient's current illness appears to be routine, the paramedic would prescribe the necessary basic treatment, updating with an online computer, the patient's medical record. If simple medication is required, he would enter the prescription into the computer, which would record the prescription and send it to the central pharmacy at the medical center for filling. A computer would type the prescription label. Within a half hour of the patient's call to the paramedics, the medication could arrive at the patient's residence via the automatic delivery system.
The paramedic requires more training than a registered nurse but less than a general practitioner. The paramedic works under the supervision of physicians but he has more latitude in decision making than nurses. Nevertheless, there are specific restrictions on his functions. He knows at what point he is required to call for a physician to take over the diagnosis and treatment.
The Medical Centre
The medical center is located in the core of the Future City. It would be a general medical and hospital facility consisting of surgery and emergency units, radiology, and pathology laboratories, a pharmacy, specialized ambulatory clinics, a dietary department and kitchen facilities, a blood bank, the medical records data-bank and computer facility, a medical school and medical research facility, and an intensive care unit (ICU) consisting of about 100 beds. In the ICU, the vital functions of patients would be monitored and any unexpected developments in the treatment of a patient would cause an automatic signal to alert the medical personnel on duty.
The Acute-Care Centre
If the patient requires hospitalization or more extensive testing arrangements for that care would be made through the neighbourhood sector clinic. It would take approximately five minutes by auto for the patient to arrive at the acute-care hospital located at the medical center in the Core. While he is en route to the hospital arrangemtns could be made so that he could be immediately tended to when he arrives, and he would go without delay directly to a room or to a test facility as required.
Extended Care Facility
As the patient recovers, he would no longer require the level of care ordinarily furnished in a short-term acute-care hospital. However, he might still continue to need a professional level of medical supervision, skilled nursing care, and related services. Because residences would be located so close to medical facilities, extended care could usually be given in the home. Necessary equipment might be loaned, and delivered by the automatic delivery system. Medical advice in such cases would be transferred back to the sector facility.
In some cases however, the patient would be moved
to an extended-care facility located
"down the hall" from the acute-care hospital. The extended-care facility would have less expensive technical equipment and less medical staff per patient. In case of a relapse, the patient could be moved back to the acute-care facility in a few minutes. It is obvious that the convenient special arrangements of the medical facilities and personnel and their around-the-clock use would result in great savings and better services.
For most of the times, the patients who need an extended-care
facility are those persons past middle age who suffer from heart trouble, strokes,
or cancer. As the diseases of infancy, childhood, and the early adult years
are conquered, more people will be kept alive and will eventually by default
fall victim to these disabling diseases. From the past till the present, the
number of such people has increased greatly. Thus, there is a growing need for
more and more facilities that provide extended care.