Let’s Hear a Cheer for Efficiency!

For years, I have been complaining about a system that pays for procedures but not care. Has someone heard me? I doubt it. It isn’t the need to improve care, unfortunately, that has brought this about. It is the need to contain costs. What an idea! With one central doctor to coordinate care, there would be more efficiency in that care, fewer mistakes, fewer duplicated and costly tests. Seems to me this used to be called family medicine.

As a patient, I try to take an active role in my care.. That can be difficult. Like the time I said that I didn’t need a battery of blood tests because I had had them just two months before and they were all normal. The looks that I got were interesting. This upstart patient trying to second guess her physician! It was like the time that I said I didn’t want a chest x-ray before surgery. If my lungs sounded clear, why did I need it? Or the time I demanded to see a faculty anesthesiologist rather than deal with residents who had had about one weeks training. I kept insisting (I have had reactions to anesthetics.) until it was obvious I was holding up the surgery schedule. No points gained there. Just some assurance for me that the original mistake would not be repeated. And there was the time I was reading my chart on the way to surgery when I found the lab results for two other people in my chart. Two absolute strangers were part of my medical record! That got their attention. And so it goes.

One very wise physician I used to work with told this story. His patient had broken her hip so he called in the orthopedic surgeons who in turn called in a cardiologist since she was of an age. He felt she was in good hands and left the care to others until he received a call from his patient’s daughter.

“Mother is having some problems with discomfort and with constipation,” she complained. “She has a surgeon to repair her hip, She has a heart doctor to care for her heart. But who is taking care of Mother?” Just who was taking care of all of her—the whole person?
If it takes a push for efficiency to bring about this return to old time medicine when your family doctor coordinated your care, I will applaud loudly. And all you patients out there, let your voice be heard. This is the best news from the field of health care in many a blue or any other colored moon.
http://www.nytimes.com/2008/07/21/business/21medhome.html?ref=health

by Kae Hentges