Care guidelines and protocols are designed to address discreet aspects of health, not necessarily the complexities of the human condition. When Dr. Elvin Geng of Washington University in St. Louis realized standard rules and practice were preventing him from addressing a complicated issue for a patient, he recognized the situation called for more discretionary decision making, evidence of what our second guest, author Michael Lipsky, discusses in his seminal book "The Street-Level Bureaucrat." Find out how this concept relates to health care and how it is now shaping the way care is delivered.