Chaos and Organization in Health Care

Chaos and Organization in Health Care

By Thomas H. Lee and James J. Mongan

With Laura Cushing-Kidney

Two leading physicians' prescription for solving our health care problems: organizing the fragmented system that delivers care.





Two leading physicians' prescription for solving our health care problems: organizing the fragmented system that delivers care.

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.


Out of Print ISBN: 9780262013536 296 pp. | 6 in x 9 in 19 figures


$17.00 T ISBN: 9780262517621 296 pp. | 6 in x 9 in 19 figures


Laura Cushing-Kidney.


  • Dr. Lee and Dr. Mongan present a compelling vision of a more efficient, reliable, and patient-centered healthcare system. The authors' call for fundamental payment and delivery system reform to achieve an integrated delivery system accountable for achieving the best health outcomes and prudent use of resources is right on target. Strong leadership from the provider community like this is exactly what's needed to lead the U.S. health care system towards higher performance, lower cost, and better care.

    Karen Davis

    President, The Commonwealth Fund

  • The toughest part of health reform will be after the politicians finish with us, and we health care insiders have to figure out how to create a higher-quality system that is more affordable. Refreshingly frank, non-partisan, and easy to read, Chaos and Organization in Health Care takes on this challenge and lays out a vision for how our system can achieve integrated care. Lee and Mongan are not afraid to take on the sacred cows of the delivery system and they do so in an entertaining way. I highly recommend this book to physicians as well as anyone else involved in improving our health care system.

    Robert Galvin

    Executive Director of Health Services and Chief Medical Officer, General Electric