(originally posted on www.hospitalimpact.org)
Since writing the blog post "Continuity leads to relationship, trust and better care" an extraordinary number of people have shared similar stories with me.
In fact, a good friend of mine, who is a healthcare quality leader in Maine, said a recent healthcare experience really showed her how poor continuity and a lack of relationship can compromise care.
She had recently booked her routine office exam, but in doing so was informed she could not see her regular physician but rather she would see another physician who is part of the same care team. She decided to take the appointment and soon was in for her visit.
As part of her exam they performed an EKG. The doctor looked at the results and appeared puzzled. The unfamiliar doctor apparently saw some things that concerned her but eventually said stoically: "You're fine. No problem." My friend, being a nurse and working in healthcare quality, responded that she wanted to hear and see what was initially concerning, as well as discuss why the doctor did not believe there was a problem. The doctor coldly and quickly assured her that there was no problem, she was fine and then shortly thereafter left the room to see more patients.
My friend was aghast. "Is this healthcare?" "Is this caring?" "Why do I feel worse after my visit?"
She went home straightaway and told her husband that they were both going to leave this physician practice and find their former doctor ... the one that knew them both and whom they trusted (albeit the one whose office is a good distance away). "Rotating physicians who have little relationship and minimal time with patients and thus who don't truly know their patients are not how best to help people," she shared with me.
She did eventually get in to see HER doctor (the one that knew her and her husband) and with ample time and an opportunity to share fears and concerns did receive confirmation from HER doctor that indeed her EKG was fine and there was nothing to worry about.
"Healthcare the way it should be!" she concluded. The way it should be ... yes ... but clearly not normative in our broken healthcare "system."
As A Country Doctor, MD, shared in a recent blog: "Continuity of care starts with caring." Yes ... caring. And yet in speaking recently with a local healthcare leader (with great influence in the community) I found that even though this leader logically understood and acknowledged the importance of these aspects of healing (and could share his own stories), translating the importance of time, relationship, caring, continuity, trust and empathy into the healthcare model in his eyes is not yet "practical" and may not provide "longitudinal financial success" to healthcare organizations.
Now I truly understand that there is a wide-variety of solutions to our broken healthcare model. And I also believe that one size does not necessarily fit all. But again, the foundation of healthcare is CARE. Time, relationship, continuity, trust and empathy are all key components of caring and stated as such in the Hippocratic Oath.
So, again it still amazes me how important these aspects are to healing AND how consistently the healthcare "system" considers them "impractical" or worse, sets them aside to ensure "longitudinal financial success."
To continue to sacrifice the health of our friends, families and communities for "longitudinal financial success" is appalling and highlights another side of a "sick" system.
It is time to heal the sick system.