"Why You May Not Be Getting the Healthcare You Need" by Dr. Brian Rank
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By Dr. Brian Rank, member of the Quality committee
"Between the health care we receive and the care we should be getting, there exists not just a gap, but a chasm." This conclusion about the state of health care in America, published in 2001 in the Institute of Medicine report Crossing the Quality Chasm, somehow got lost in the flood of information that washes over us daily.
Now, a study by the National Committee for Quality Assurance has brought the inadequacy of America's health care system once again to the forefront, pointing out that 57,000 Americans die needlessly every year because they don't receive the appropriate care.
It's a familiar story. Earlier this year, a Rand Health study confirmed the scathing indictment of the IOM report by pointing out that American adults are getting only 55 percent of the medical services they need.
None of these stories made headlines in most papers, and they are already in danger of slipping from our collective consciousness. The result: Americans get less than optimal care, resulting in pain, suffering and needless death.
The Rand study pointed out that less than half of all diabetes patients have their blood sugars tested on a regular basis, less than 65 percent of patients with high blood pressure receive recommended care, and only 45 percent of heart attack patients get medications that could significantly reduce their risk of death. If we applied this rate of error to airlines, there would be a crash every day of the week. We wouldn't put up with that.
There are many reason for our dilemma, including a system that pays physicians for the procedures with no regard to the quality of the care. Patients, payers and providers all have a hand in this. Yet our collective focus must not be on fixing blame, but rather on fixing the system.
At HealthPartners, we've used funds awarded to us by the Robert Wood Johnson Foundation through a grant called Pursuing Perfection to improve the way we deliver care.
We think health care needs to focus on patient needs. It should also have fewer waits and delays, provide the highest quality, be more efficient, and be much safer.
For example, we're focusing on providing care not just during your appointment but before, after and in between, appointments. Our receptionists review appointment schedules each day to ensure that each patient receives the right amount of time for his or her needs. If patients wish, a registered nurse on the team will schedule lab tests for them, prior to meeting with their doctor so that they can discuss any abnormal tests together during the office visit. The team also follows-up with patients who should be coming in for care who have not had a recent appointment.
We have enlisted patients to collaborate in designing new systems and to provide advice about what's important to them. New technology is helping us reduce waste and needless complexity, which can help decrease the cost of care, make it safer to deliver, and help doctors and nurses to do the right things.
We are making progress. In comparison with the Rand study, nearly 90 percent of our diabetes patients have regular testing for better control of blood sugar levels and cholesterol. Even a higher percentage of our patients receive proper medication after heart attacks protecting them from further injury.
As patients, you should demand better care from your health system. Here are some suggestions:
- Work with your doctor, nurse and other health care providers to make decisions about your care.
- Tell your doctor about your allergies and medications you take including prescription drugs, over the counter medications, vitamins and herbs.
- Read the label of your prescription right away to make sure its what your doctor ordered. If you have questions, ask.
- If you have several health problems and have many people involved in your care. Find out who is in charge and speak often with that person. If needed, ask a friend or family member to help.
- Ask questions and keep asking them until you get the answers you need. You have a right to speak with anyone who is involved in your care.
Between new health care systems and patients taking part in their own care, we can look forward to a time when future Rand studies demonstrate not how bad our current health car system is, but how good it has become.
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