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Squeezing out the doctor

In a windowless room on a quiet street in Framingham, outside Boston, Rob Goudswaard and his colleagues are trying to unpick the knottiest problem in health care: how to look after an ageing and thus sickening population efficiently. The walls are plastered with photographs of typical patients—here a man who exercises occasionally, there a woman with many chronic ailments. Big sheets of paper chart each patient's course from the hospital back to a comfortable life at home, with divergent lines showing all the problems that might arise and ways to handle them. To map the many paths to health in this way Mr Goudswaard's team interviewed a lot of patients and…

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