Patient Centered Health Care

Health care is no longer centered on the patient. It is centered on rules, bureaucracy, regulations, insurance companies, and government.

Here are some of the problems with the current system:

• Information cannot be shared about your health easily. Not a problem if you are a conscious liberal concerned about your privacy, but a big problem if you have cognitive problems and your health information is scattered. For example, a patient with a brain hemorrhage was transferred to our hospital for rehab. While there, he deteriorated and became comatose. A CT brain scan showed a large hemorrhage with brainstem compression, but was this new, progressive, or the same as before? We had a report from the referring hospital which was unclear about the mass effect. When we requested the films from the other hospital to compare studies, they wouldn't release them without a HIPPA release. We called in the wife who signed the release, but the other hospital wasn't satisfied. "Why didn't the patient sign?" they asked. Of course, under HIPPA, we cannot tell them why, as we would be disclosing health care information. Eventually, they agreed to send us...a report, not the films. Why? They said they didn't have any films! So, we decided to send the patient to them for re-evaluation. The doctor there initially refused to accept the patient, as he was convinced that there was nothing wrong. An attempt was made to send the patient to the emergency room, but this was a violation of EMTALA. So, eventually, the patient was sent to an ICU. All this because a film could not (or would not) be sent. No common sense. No patient-centered thinking.
• If you have a condition that is best treated by a medication that your health insurance doesn't have on it's formulary, good luck! This happens frequently. If you are lucky, you get it with a high co-pay. Or perhaps, you and your doctor agree on using something less optimal for your care. How good is that?
• If you have something unusual and there is a treatment for your problem that is well documented in the medical literature, but for some reason your doctor has not read about it, pharmaceutical representatives are forbidden to let your doctor know even if your doctor asks, unless that information is allowed by the FDA. How is that FDA regulation patient centered? It is more based upon the fear of sleazy marketing practices than upon your need for help as a patient.
• Truly, doctors, hospitals, nurses, and pharmaceutical companies try to provide for your health in an increasingly frictioned and hostile legal, bureaucratic, regulated, "managed", insurance based environment. Is the current system working? Patients still die in the hospital from medical errors, so you be the judge! The cause of the errors is the system, not the people. And the doctors, nurses, hospitals, and pharma companies are on the receiving end of the rules. We are not the problem. We are the solution.
• When pharma makes a profit, it plows the money back into research or into giving free or reduced price medications to those in financial need. When doctors and hospitals make a profit, they spend it on either bringing more services to the area, hiring more people, or buying goods and services, generally locally. When health insurance companies "make a profit" they spend and use it to further their image. They buy advertising in sports stadiums, TV ads, planes, buildings, donate it to symphonies, etc. Guess what? It isn't their money! It is the hard earned money of the subscribers to their plans. These subscribers get less care and don't even get the surplus back as a rebate against future premiums! The true enemies of good health are the government, the health insurance companies, and to a lesser extent malpractice attorneys. However, they have framed the issue of health care to make it look like they are the good guys in white hats. The AMA and PHARMA have sat back and accepted the framing of the issues, doing neither their constituents or the public a good service. It is time that doctors, nurses and hospitals take back health care from big government, big insurance, and big law. It is time to free the pharma companies to bring the excellent products in development to us, the patients. It is time to make the USA a great place to do pharma research, bringing jobs and talented people to our country. And, it is time to bring back charity in health care. Time to give back, to pay it forward. Time to give patients what they need in the way they want it. To paraphrase JFK, ich bin patient.