Keeping patients at the center of our business model is important to us. Yesterday, Care on Location was present at the #PrimeHealth gathering for "Patient Centered Care: What does this mean?"
Physicians, patient advocates, patients and other healthcare stakeholders were present to bring together all sides in an attempt to discuss, find solutions, and to solve problems of our obviously imperfect healthcare system. Much of the conversation revolved around the severe handicap that time and money place on quality care. Incentives are misaligned, expectations are skewed, and the problem is massively complex. But, we are beginning to Reimagine, Repair, & Replace the current system thanks to a multitude of startup companies trying to do it right for the patient. Once these catch on and join forces, we will see some significant improvement. In the meantime, keep pressure on the current powers to do the right thing and keep this about our shared humanity.
There we several common themes that came up which I will briefly mention here:
Listening - Several of the patient comments centered around the fact that the healthcare providers do not take the time to truly listen to them. The providers are under such a time constraint or are financially motivated such that they are not willing to take the time to try to get to the heart of a patient issue. This was particularly magnified for patients with multiple and chronic medical issues. With the average patient office visit of 15 minutes, the actual face-time with a doctor is usually significantly less. Because of this brief interaction, the patient rarely has the opportunity to voice their full concerns. As a matter of fact, several studies show that even when they try, the physician tends to cut them off after about 20 seconds to redirect them.
Inefficient Testing - The current healthcare system exists in silos. This means that each healthcare company, office, lab, tends to work separately from all the others. There is little sharing of information. While this is starting to change, it is still the norm. Because information is not commonly shared, as the patient moves from one healthcare location to another, important data points and pieces of information can be missed which could lead to a bad outcome for the patient. In order to not miss something important, the healthcare providers may re-order a test that had already been done because it is faster to do a test again than it is to try to get the result of the recently performed one. This leads to added burden, expense and risk to the patient and added cost to the healthcare system in general.
A Focus on Money- While many patients would benefit from having a dietitian, a physical therapist, and a healthcare navigator that could explain the most efficient way to manage the system, these services generally are not covered by many plans. Insurance companies are a multi-layered complex set of organizations who have at the core of their model to make a profit. The money they collect must be greater than the money they spend. While this is logical for a business to stay in business, when the size of the profit margin is more important than the health of the patient, then the priorities are wrong. According to A.M. Best rating company, the health insurance industry had an increase in income of $13.1 billion in 2016 which is 46% higher than the year prior.
A Focus on "Sick" and not on "Well"- American has an inverted healthcare provider base where we have more specialists than we have primary care physicians. The current payment system is Fee For Service(FFS) where the physicians get paid to "do something" when you are sick but don't get paid as much to keep you healthy. This incentive structure along with the higher cost, higher quantity of specialists means that more "things" get done to patients which drives up cost and complications. With all of our spending on healthcare, the US is not leading the pack when it comes to the quality of outcomes patients should expect. As a matter of fact, the Commonwealth Fund reports that we have the lowest life expectancy and highest infant mortality out of 13 industrialized nations while outspending each of them per capita.
These are just a few of the issues raised. There are many more where they came from. At Care on Location we are tackling the inefficiency and the money component but mainly we are focused on putting the patient at the core of our values. Let us help, advise, or guide you for a relatively small cost compared to most medical interactions.
Photo courtesy of Mishio: https://creativecommons.org/licenses/by/2.0/