Ailing health system: Feed it or heal it?
If patients and providers don't ask the right questions, they won't get the right answers.
By THOMAS DAHLBORG June 18, 2008
(Submitted to Portland Press Herald - Maine Voices)
As the debate over health care continues in our state, along with the important questions about how we will pay for health care, we should also be asking what we are paying for.
We need to know whether or not it is worth it, and whether we could be paying for different things that could make more of an impact on the health and well-being of Maine citizens.
As I talk with practitioners around the state (many of whom are burnt out and discouraged), I hear things like "my patient panel is over 4,000," "I am obligated to see 30 patients a day," and "how do you squeeze 10 patients into an hour and still give quality care?"
Medical residents have also shared that one goal of their residency programs is to train them how to see more patients in a shorter amount of time. It is disheartening to see that much of the creative energy in health care is around innovation regarding the finances of health care as opposed to innovation that leads to real healing in patients.
When you consider your most recent experiences with the health care system, have you asked yourself any of the following:
How long did my physician spend with me? Do I have more or less (or the same) time with my physician as I did last year? Did he/she really care about me? Was I really cared for? Did I feel a connection with my physician? Does my physician know my name? Does my physician know me and the circumstances of my life?
Further, is my health getting incrementally better or worse? Is the health care system getting incrementally better or worse? What happens when I share mental health issues with my physician? Is love part of my visit, or fear? Does my insurance cover what I need and want?
In a system where the financial bottom line drives many of the norms, what is a physician to do?
As my colleague, Dr. Bethany Hays, often notes, health care is full of good people, called to the work they love but who are trapped in a broken system. These people are working as hard as they can in a broken system because they know people need and want help.
Innovation in health care should to lead to a healthier system for patients and practitioners alike.
When patients and practitioners deal with each other directly for an hour or more at a time, they are able to develop trust and a real relationship. They are better able to evaluate what is going on in the healing relationship and what its value is.
When both the patient and practitioner are in the know about the finances of health care, and when they have a true relationship and an understanding of the physical, mental, social, financial and spiritual issues impacting the patient's health, they can make decisions about treatment plans with a complete picture of the patient's situation in mind.
And with this wisdom and caring, the patient is far better positioned for healing and long term wellness.
Chronic health-care conditions are one of our most expensive issues from both a financial and human perspective. Human beings are complex, evolving systems and understanding how to cure illness involves treating patients as the multifaceted people they are -- rather than merely a collection of symptoms that can be suppressed by drugs or surgery alone.
Taking the first approach means taking time and building relationships, as well as a commitment on the part of patients to take responsibility for their part of the equation.
Innovation around real healing should be the focus of our efforts to reform health care, rather than on continuing to feed an unhealthy system that takes more than it can ever hope to give.