Interesting view on US Health Care

I was reading over this blog that I follow
http://diseasemanagementcareblog.blogspot.com/
it's Posted by Jaan Sidorov

Jaan's takeaways was this based on the research that was presented in his blog.

DMCB takeaways:

If other developed nations are role models for the U.S., large clinic systems are not necessarily the way to go.

There may be an inverse correlation between patients' ability to pay for care and access to specialist care.

The U.S. is in the middle of the pack when it comes to EHR use.

Nurse-led care manage is not uncommon overseas and a 43% rate in the U.S. is higher than generally realized.

Timely transmittal of emergency room and hospital discharge information seems to be a problem everywhere.


I find it interesting because we are at a crossroads where we look to fundamentally change how we do healthcare  in the US.  The ACA is beginning to get implemented at a much higher rate in 2013.  The results to be honest have been less than impressive.  The goal was to make health better and cheaper not created endless bureaucracy,  Jaan's last 2 points I find really interesting. In many countries your provider is a nurse and not a doctor. Sometimes it's because there isn't a doctor available or because the system in place has you go through a "triage" before you get to see a physician.  In the US we prefer to see the "doctor" becuase that's the expectation. Working in a healthcare system setting, there are times I'd rather see a nurse who has 20 years under her belt than a resident just out of school.. It's something that we might need to consider more.  Plus its more cost effective and it give the Dr's time to work with patients rather than squeeze them in for 17 minute visits.

The other point is the exchange of info with the ER and discharge.  We frankly we stink at this and the issue is really on both the Dr. and the patient.  Most times you get out of the ER and the attending gives you the paperwork and it good bye. They usually don't follow up with the primary.  Unless they happen to work in the same hospital. On the flip side the patient needs to show an iota of common sense and let his primary know what happen.  Now if this person doesn't have coverage or a primary that's another whole issue.  I think this trend is changing with the ER. Now what needs to happen is the patient needs to show some personal responsibility and get penalized when they don't.  Because if they don't we all have to pay in the long run.

I'm not a big fan of the ACA  just because it was to huge and was way too partisan.  Though I agree with it in the spirit that the system is broken and needs to be fixed.  I really hope 2013 the Senate gets its act together and allows some bills to be voted on that could fix a few things on this act. Though based on Harry Reid's track record I won't hold my breathe.  On the other hand the house should stop wasting its time on trying repeal and focus on fixing the act incrementally with the areas that have the biggest flaws. You'll get more support that way.

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