The health care conversations we should be having.
Posted: Jul 27, 2017
With new headlines every day about health care reform, it’s easy to lose track of what’s happening. Are we talking about reducing Medicaid coverage by 22 million people—or something even worse?
While the national dialogue focuses on insurance specifics, care itself fades into the background. We should be focused on health care coverage. But we should also be talking about the quality of care that’s offered.
At Pyramid, we partner with many health organizations working to transform care and address the issues that so many of us either take for granted, or don’t even think of yet as issues. They’re relevant to all of us in varying degrees.
Here are some of the care conversations my clients are having and are at the top of my mind—along with steps you can take to help improve the care we all receive.
More humanity needs to be shown when health care goes wrong.
When something goes wrong with your care, for instance a doctor leaves a piece of cotton gauze in your body after surgery that causes infection—you’d likely want to know how it happened and receive an apology. Right? But the most common practice in that situation is for institutions and their providers to shut down all communication and leave it for the lawyers. It’s incredibly painful to patients who are harmed, and for the providers who feel guilt, regret, and even shame. We need to talk about how the health care system can open up communication when errors occur and talk with patients and their families as humans.
What you can do:
- Before you have a medical procedure, ask your physician if their institution has a communication and resolution program in place. If they don’t, refer them to the Collaborative for Accountability and Improvement to learn more.
Unnecessary tests, treatments, and prescriptions can create more harm than good.
How often have you been to your doctor with a virus and been told that they can prescribe antibiotics—which only work on bacterial infections—if you want them? It’s not uncommon for doctors to prescribe medications or treatments that aren’t helpful and can do you harm or public health at large. Fortunately, our health care system is beginning to act, but it’s difficult to change behaviors when we, as a society, live by the mantra that more is better. There are hundreds of prescriptions and treatments we don’t need and that have the potential to create more harm than good. We need to talk about medical overuse and what patients can do to step into our roles as co-pilots of our own care.
What you can do:
- Become a partner in your care and ask questions about the necessity, benefits, and potential harm of prescriptions, tests, and treatments. Check out the resources available for patients from the Choosing Wisely initiative.
- Send interested physicians to Taking Action on Overuse, a new model care teams can apply to reduce medical overuse.
Social and economic factors are significantly shaping the health of many Americans.
People with the privilege of education, a good job—especially one in health care—and housing in the right zip code, most likely have the power to prevent or manage any moderate health issues that arise. That’s not the case for everyone. People experiencing racism, poverty, unstable housing, or other related factors, may see health as a mirage. Healthy food is often expensive, stress and trauma take tolls on the body and psyche, and many health conditions go untreated because they’re unaffordable. These challenges can lead to homelessness and unneeded suffering. We need to talk about how the health care system must address these social and economic factors that significantly impact the health of many Americans.
What you can do:
- Become educated about the social and economic factors that shape health and share what you learn with family, friends and colleagues. Go deep with this Kaiser Family Foundation study or check out this page on social determinants of health from the Oregon Primary Care Association.
- Support local levies for human services and mental health coverage.
- Support your local federally qualified health center, which is dedicated to providing care to people experiencing poverty, marginalization, and related challenges. Find them via your local primary care association.
- If you’re part of a primary care team, access tools and resources from the Oregon Primary Care Association.
Let’s start talking with our care teams, physicians, families, friends, and colleagues about the kind of health care system we want—and can have. For starters, I know I want it to demand transparent communication, to respect my own experience and knowledge, and to offer equitable, humane care to all Americans. What do you want?