I have been considering what is at the core of the issues that we have with the healthcare industry. One of the issues that comes up over and over again is the lack of connection between patients, doctors, nurses, insurance companies, hospitals, etc.

 

Healthcare roles are complicated and many healthcare workers are overworked. Thus, it is not surprising that many healthcare workers don’t understand a lot about other aspects of healthcare outside their specific role. However, that puts the patient in the position of handling their own healthcare inside a system that is full of flaws.

 

Flaws  In The System

 

The flaws in the system start with the paperwork, where the same information is entered over and over. Then, you talk to a nurse or medical technician, who asks you all the same questions. They may or may not enter it into the computer at that time. Now, enter the doctor who asks at least part of the questions again. (And, they wonder why people have high blood pressure.)

 

It make sense to double check some things or verify things where the answer is unclear. However, it makes a patient wonder why they are filling out the forms. Of course, it is sometimes far easier to ask the patient the question than read their handwriting or find the answer among the general history questions that have nothing to do with the problem at hand.

 

Best Interest In Mind

 

Still, I believe doctors and their staffs generally have the patient’s best interest in mind. They prescribe the treatments, surgery, and medicines that they believe will help the patient. The issue is that they have no idea how much these treatments cost the patient. I would really hate for them to make decisions on treatments based on cost. On the other hand, when there are two viable options, the doctor could choose a less expensive option if they knew the cost.

 

Whose Interest In Mind?

 

Hospitals, on the other hand, appear to be focused solely on making money. Patient care is a statistic to meet a government guideline or rule. They are worried about being penalized and/or meeting requirements that are financially beneficial to them. Often these rules are contradictory and not aligned with providing the best patient case despite that being the supposed goal.

 

The pharmaceutical companies and pharmacies also play a role. The pharmaceutical companies decide what to research and how much to charge for the drugs that they create. Like hospitals, they are about making money, which is not a good thing for the patient. They search for ways to address symptoms rather than cure diseases because they have no incentive to find cures.

 

The pharmacies, along with government regulations, decide when you can get medicine that is prescribed to you. The rules are different for mail pharmacies and local pharmacies. In the case of local pharmacies, often you cannot get your prescription refilled until less than a week before you run out. This is a huge issue for patients when living in rural areas where it is miles to town or when someone travels. It is not uncommon in these situations for the patient to be required to take extraordinary steps to get their medication.

 

Codes, Codes, And More Codes

 

Now, enter the insurance companies whose goal it is to limit expenses. They question everything, but generally speaking the staff questioning the need for treatment has little if any medical training. They know nothing of the patients’ situation outside the “codes” and they don’t trust the expert’s opinion.   Thus, someone completely unconnected to the patient and their situation is attempting to alter or limit the patient’s care.

 

This is a recipe for disaster. Unfortunately, it means lots of time and dollars are wasted arguing about how much money is going to be spent. The patient, in turn, ends up spending time getting it figured out or making sure that someone is figuring it out. In many situations, the prescribed treatment is approved, but at what cost?

 

In Part II “Connected Healthcare,” we will discuss an alternate healthcare system that connects care to the patient at every step.

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