Some years ago, a physician friend told me this story, and it has remained with me. He was one of the finest diagnosticians around and highly respected for his medical skills. He was visiting with his family members at his daughters home and realized he was in the process of having a heart attack. He requested his son immediately take him to the hospital. There was a hospital with an emergency room quite close. However, even in the midst of his coronary, he insisted that his son drive to another hospital that had a highly respected coronary team.
I asked him, "Why didn't you go to the first emergency room?"
I'm still startled by his response.
"Because I thought the quality of care there would kill me."
It was worth the risk of continuing to the drive to get to a facility he believed was highly qualified to handle his cardiac event.One size does not fit all and all providers of healthcare are not comparable. There are numerous entry points into the system and choosing the right entry point can be the most critical choice in the process. So what doors are worth going through and what do you look for in quality medical access?
Know your facilities and their specialties.
My friend's story really defines the concept of access to healthcare. The reality is hospitals and providers have varying skill levels that are discernible only to those who spend their lives understanding our healthcare system and how it really operates. In the hospital world there are notable centers of excellence for all of the critical specialties in medicine. When you evaluate where to receive care the evaluation must begin with a determination of exactly what is the problem? Once we have a sense of what the problem is only then can we begin to look to find a provider or center of excellence most qualified to provide the care required. Since we don't have the skills that my friend the physician had in determining that he was in fact experiencing a coronary we need to rely upon the expertise of others to lead us to making good judgments.
Find Doctors that Respect You and Your Time
Access is not just a concern in an emergency situation. During routine visits with our providers we often experience the indignity of the devaluation of our time as compared to that of the provider. In a "Huffington Post" article, Inga Offen wrote about finding the following sign at a local doctor’s office she was visiting:
"'Please be advised that your waiting time could be extensive. If you are unable to continue your wait, please let the receptionist know and she will reschedule your appointment. Thank you for your understanding and patience as the doctor takes the time to provide excellent medical care to all.'"
Ms. Offen offered a translation of the above note.
"'We make absolutely no effort to schedule in any meaningful way or to respect the time and comfort of our patients. Be prepared to sit here all afternoon because we have egos the size of Connecticut and think the sun rises and sets on our board certified tushies. Should you get so fed up that you leave, our hostile office staff will assure you that the same thing will happen the next time so you might as well suck it up and stay since you’ve already paid for parking. Regardless, we’re keeping your co-pay'”
The translation you just read is in fact harsh, but I doubt that anyone who takes the time to read this article will deny that they too have experienced this disregard of their time and value at a physician's office. In fact, when we have those unusually high blood pressure readings often referred to as "white coat syndrome", they may really reflect our frustration from the excess time we have spent attempting to obtain medical care. Let's not forget the time we spent on the phone attempting to coordinate our care or make an appointment to be seen by our physician.
Know Your Doctors Limitations
The current model for most healthcare, never demands excellence nor efficiency as it expects the patient's to be available and accommodating.The referral patterns with both hospital employed physicians and private practice physicians are dictated by the networks and relationships they establish which usually are mutually beneficial. For example, employed physicians in a health care system are "expected" to refer to specialists within the system. That is simply how it works.
Should you as a patient want to go beyond that system to ensure you are receiving care from the most highly qualified provider you are very much on your own. You need to figure it out and coordinate the care on your own. This requires both expertise and significant blocks of time to navigate the health care maze in each of these varying systems. The providers fully understand the complexities of the system and rely upon patient inertia to move them through utilizing their service model.
There are alternatives to explore beyond this most common model. The Concierge Healthcare Management Model, for example, is a patient centric system. Choosing the best providers and expecting them to perform at the highest level and quality with consideration for the patient is the focus. Going around the red-tape to evaluating the needs of the patient over that of any particular health-care system ensures the patient is more likely to receive the best care for their situation.
Demand this Service Industry Serve You.
In each of the above scenarios there is an overarching theme. Healthcare differs from almost every other form of a service business in our society. Nearly all service businesses have a singular focus on the customer. Only healthcare is provider centric, where the terms of engagement are established by the provider and the recipient of the service is expected to accept those terms. Access should mean providing the highest quality of care in the most expeditious manner, while maintaining at all times the patient's dignity and sense of self.
Note from CEO, Mark Schlussel
Access to quality healthcare is knowledge driven. We at Curus focus our attention on the details of care.
Each member of Curus is unique. That is why we tailor their care to suit them.