Recently, I hear more and more about who to trust and how in health care. Simply put, trust has eroded over the last decade or more between health care providers, payers, patients and other sectors whose livelihoods and health depend on good and affordable health care.
Ok, I'll call it the way that I see it: a common denominator getting in the way of making things better here is fear. So, how does that work: Patient's are afraid that they will not be able to see their caregivers or have enough time with them. They fear the fees that they are charged, the amounts their carriers will not cover, the complexity of even understanding the paper work, the EOB, the Explanation of Benefits. Many can't afford the care they need with or without insurance. Many don't have insurance at all. This is before they even begin to take care of the very thing that brought them: their health or their illness.
That is where the focus should be. It's essential that we make that happen.
Health care providers fear that they can't keep up with the patient loads that they see, don't have adequate time to see them. At times they feel that they must order complex and expensive testing that in their clinical judgment isn't required just to protect themselves from lawsuits.
There is a shortage of nursing care. The fact is that the number of patients that each nurse cares for directly correlates to safety in a hospital. Fewer nurses equate to more patients per nurse and that equates to less safety for the patients.
On a broader level, we have a serious problem with the management and cost of chronic illness: Congestive Heart Failure, Diabetes, Obesity, Depression, to name just the beginning of illnesses that have a huge behavioral component to them. Collectively, we are not doing well with these illnesses and helping those afflicted with them to change their behaviors sufficiently. So, chronic illness absorbs huge amounts of the dollars spent on health care and aside from the cost, we know too little about how to produce wide scale behavioral change in those who are afflicted to help them.
This is just the tip of the iceberg. It is not a pretty picture. We have a system of health care providers, patients, payers, legislators, economists who don't know how to solve this crisis.
This is all pretty complex and has to be tackled at a lot of levels. One underlying piece has to named as well: Fear and Lack of Trust. It is rarely talked about. Trust is not rampant around here. It is hard to find and has to be found. All the plans, negotiations, financial plans, legislation and talk will only succeed when the issue of lack of trust is addressed. We have to recognize and admit that the problem is so vast that it can only be addressed collectively. We have to establish ties to one another that are meant to provide for the common good of all That's when we will we have a chance to make progress.
I suppose we will have to take all the time that we need to make this problem get better. But, it seems to me that time has been running out for a long time. When each of us takes that attitude that we will demonstrate a trusting approach to our part and insist that others do as well then we can begin to progress. When we all hold ourselves accountable for our part in making things better in health care then we have a place to start.
As they say, you gotta start somewhere.
Robert Fisher, MD, CEO/Founder Future of Healthcare Forums Tm copyrightrfisher2007
Call to action: please add your comment to this post. How does it apply to you?
Recent Comments