“The United States healthcare system is the most expensive in the world, but when it comes to health outcomes; it performs worse than 11 other similar industrialized nations, according to a new report released by the Commonwealth Fund.” ~ “US healthcare most expensive and worst performing”, The Atlantic, June 16, 2014
Is Your Medical Care Fragmented? It is clear from the Commonwealth Fund report that, despite what we spend, our system is flawed. One of the many problems that stand out to me is fragmentation in patient care.
In a previous blog I wrote about Ann who, while enrolled in hospice, was seen by her oncologist to evaluate her anemia and order tests. The oncologist had no idea that I had already done so and that Ann had a terminal cardiac condition. The oncologist also did not inquire about past records in order to fully understand Ann’s condition. I have grave concerns that these kinds of challenges in sharing information will ultimately lead to fragmentation in patient care. This then results in unnecessary and costly testing, diagnoses, and subsequent patient anxiety. There is a real potential of someone prescribing unnecessary intervention and treatment.
What can be done about this problem? How can we prevent this from happening to ourselves, or to our loved ones? I grapple with these questions daily.
I have recommended the following five steps for anyone to follow in order to promote continuity of care:
1. Do not assume that your medical specialist or primary physician will have up-to-date records.
2. Obtain a copy of your patient summary at the conclusion of every medical visit and have it available when visiting any other physician or specialist.
3. Be prepared for your visits to all of your physicians. Don’t assume that they’ve done any homework or a chart review prior to your visit or that they will remember all the nuances of your case, unless you have been a patient for a very long time.
4. Consider what your desired outcome for the visit is even before the encounter begins. As I state in my book: “begin with the end in mind”.
5. Ask your doctors to communicate with one another by phone as necessary to coordinate your care and to reduce duplication of testing.
In consideration of these 5 recommendations, take responsibility for being informed and prepared when it comes to your care. Partner with Physicians or any member of your healthcare team in making decisions. Advocate for yourself by keeping open communication with medical professionals to ensure YOUR care does not become fragmented.
What are you doing to advocate your care with medical professional? Please share your successes with the blog readers. Any other thoughts to share?
Join the conversation on fragmented healthcare!
To a Healthy and Long Life,
David Bernstein, MD