In the endless quest for better technology and greater overall life expectancy, it almost feels as if the personal interaction with patients has been thrown lower and lower on providers' priority lists (in this country at least). Nowadays, the average American doctor spends less than 10 minutes actually talking to each patient. Meanwhile, the time a patient physically spends in the waiting room sometimes amounts to longer than the time it takes to roast a chicken.
Why is this important? Should we be concerned about the decline of the lifelong close relationship between a family and its chosen family doctor?
Why is this important? Should we be concerned about the decline of the lifelong close relationship between a family and its chosen family doctor?
Yes, from a public health perspective, we should be concerned.
There are multiple angles from which to view this issue, but the one I'll discuss today is that of patients who are lost in the transitions going from one health care facility to another, or back home and then into the hospital again.
There are a lot of possible ways patients can get 'lost' in their health care environment. A simple example is migration. Patients who go from one state to another often find themselves in a new care facility every time they get sick. The last time I checked, the American system was still not very far in the mission to connect multiple health records of the same person. So each time patients walk into a clinic for the first time, they will have to explain themselves again. Which is not a problem if patients are knowledgeable about their own conditions, and keep good records or know their own drug regimens well. Alternatively, a lot of information can be missed.
But the health care providers often don't take it upon themselves to contact each other about particular patients, even among providers which are all separated by nothing more than a few miles. Is communication between the local STD clinic and the antenatal clinic and the district hospital necessary to care for a woman with a high-risk pregnancy? Is it the patients' responsibility to initiate such exchange of information? If so, are they aware of this??? Well, to tell you the truth......I don't know either.
Another interesting issue that I was made aware of recently is the problem of hospital re-admissions. Patients who are 1. admitted into hospitals, 2. treated, then 3. released--why is it that a large number of them (15~25% or so in Michigan) end up back in the hospital for the same condition they were supposedly treated for already?
One possible explanation (and only one of many) is that patients are not properly educated in the things they need to do when they get home from the hospital. They may be frightened from their prior event, don't understand well enough how to take care of themselves on their own, and/or are unable to promptly seek the right kind of help when they need it. Patients may find it difficult to approach health care providers with their questions (i.e. they are intimidated, don't feel rapport, don't feel like doctors and nurses mean anything they say, etc.), and often they will act like they understand the jumble of health jargon being thrown at them during visits...when in fact it's all going in one ear and out the next.
This raises some more concerns about health literacy in the general population. That's a topic I may or may not pick up in my next post...unfortunately, I don't know enough about it...yet.
Keep warm everyone!!
-----
Image: FreeDigitalPhotos.net
Additional reading on hospital readmissions:
0 Response to "Lost in...Transitions"