I have been fighting the latest viral infection and seeing outpatients all week. Over that period, I have come up with several suggestions to improve healthcare, perhaps even making it more affordable. In no particular order, here they are:
- If you have an appointment, show up and ON TIME. If you cannot make your appointment, please let your doctor know as soon as possible so someone else may use the slot. What happens when you no show? Well, this past week, my no show rate ran just over 50%. We still have to pay staff and utilities and me for that time, even though we make no money without patients. To counter this issue, many clinics double book appointments. That means when folks do show up, things are completely screwed. This may be why your doctor runs late. It also happens because patients show up late, making everything downstream late.
- Try to follow your treatment plan. Insurers now want to reward quality of care and better outcomes, rather than quantity of appointments and tests. This sounds great exept I can prescribe the recommended treatment plan and discuss it with my patients until I turn blue in the face. If they do not go home and follow-through, nothing good is likely to happen. I should work harder to educate the patient so they adhere to the plan? We try, but you would not believe how hard it is to change habits.
- Consider universal medical records. The US government has given doctors all sorts of incentives to adapt electronic medical records, but virtually none of these systems can talk to each other. That means even though all your records are housed on a server "out there," someone will likely print them, slap on a cover sheet, and fax them to me if you need my subspecialty care. Sometimes these records fail to make it to the next doctor; so I am sitting in a room with someone who is uncertain why they have been referred. They were told something about an abnormal result, but the referral form says something else. We end up repeating a study, and finding something completely different.
OK, I'm going to stop my rant now. I need to see if my late patient has shown up yet.