Every year my cat gets a postcard notice from his vet when it's time to get his shots. My wife, however, has to keep her own records of when it's time for her mammography.
I love my cat. I think it's wonderful that he has such a conscientious vet. I love my wife even more and want her to stay healthy too. I would like it if she -- and I -- would get the same degree of care and professionalism as our pet enjoys. After all, we're only human. We need help keeping track of our medical histories. I think most Americans do too.
At last we may be getting help from provisions of the new federal health care legislation that seek to support primary care doctors in their work to keep us healthy. The new law understands what the medical profession knows from studies. Mortality rates dip by 19 percent, and costs drop by one- third when Americans have their own primary care doctor.
The new legislation encourages an approach to primary care known as "medical home." I have supported this type of patient-centered care for many years and continue to work for the improvements it can bring to the quality of care you and I and our families receive. Thanks to support from the American Academy of Family Physicians, the American Academy of Pediatrics, and others, 39 states already have medical home practices in place and the results are encouraging.
The medical home puts the family doctor at the center of family care again. It puts in place technology such as electronic health records and new payment structures, which reimburse primary care doctors for their roles coordinating care. This model delivers preventative care, helps patients navigate a complex health system and manage chronic conditions while it helps lower costs.
The medical home model can reduce emergency room visits by as much as 50 percent and can contribute to a 40 percent reduction in hospitalization for individuals with chronic illnesses such as asthma.
Two major innovations are at work:
Each one of us needs to have a doctor that treats our whole person, not only our heart or lungs or gallbladder.
It's time to bring more innovative approaches, such as the medical home, to primary care to help doctors do their jobs the best way possible. We will all be better for it. And, next year my cat may no longer be the only member of my family to get annual reminders for preventive care.
Follow Dr. Paul Grundy on Twitter: www.twitter.com/Pcpcc
The primary care shortage starts now - SmartPlanet
Doctor shortage looms as primary care loses its pull - USATODAY.com
Primary care - Wikipedia, the free encyclopedia
Primary Care -- Policy & Advocacy -- American Academy of Family ...
Today's medical world does nothing to encourage prevention and self help, it's all about "treating the symptoms" rather than discovering the cause and eliminating it. Individuals can meditate on their conditions and receive answers from within themselves concerning what to do. Some of those remedies would be to change from stressful jobs, learn to be pleased with a minimum of stuff, don't care about how others look at and think about you.
So many conditions are because we stress wanting a life as seen in movies, in the house across town and away from my neighbors. Anytime the focus is "me, my and I" we are bring stress and diseases upon ourselves. Doctors can't do anything about those things except treat them, usually with something to bring on a real condition needing treating. The return to and escalating known correcting remedies in and around the house and gardens would be the first step in Primary care.
RUBBISH HOSPITALS.....filthy, antiquated machinery, demoralised....RUDE staff
and your country dares to compare to the NHS......
shocking...absolutely shocking
I absolutely feel doctors should get paid for answering every question, for keeping their patients healthy. Unfortunately, like many freelancers, I pay out of pocket for everything, including preventive care, so I have to do everything possible to avoid actually going into their office to avoid the bill for $150 for a 5 min. visit. I don't know if the new health care bill will help in a situation like this--it only refers to eliminating copays (would I love a policy with a copay!) for preventive care. But forcing people with high deductibles to pay for every little thing definitely reduces the incentive for preventive care. This has to be addressed as well.
In the United States, more patients are turning to alternative and complementary medicine as part of their health care. The National Institutes of Health say that nearly 40 percent of adults have used some type therapy that isn't taught in med school.
http://www.newslook.com/videos/242916-4-in-10-americans-seek-alternative-medicine?autoplay=true
Holistic Approach to HIV
A medical project in Elandsdoorn, in South Africa works to encourage healthy lifestyles for the HIV positive, focusing on motivation as much as prevention and treatment. . http://www.newslook.com/videos/242151-holistic-approach-to-hiv?autoplay=true
For the Dr. there's the $35 co-pay per visit, 100% percent of any needed lab work or other treatment on that visit, prescriptions that my insurance won't cover the biggest part of the time.
So instead of getting prompt, early or preventative care, I let an issue go on for months until it can no longer be ignored then I go to the ER where I have a $125 co-pay and still have to meet the $1500/year deductible so I have to pay 100% of everything for the ER visit.
And co-pays go up every year like clockwork and "covered" expenses or treatments diminish every year like clockwork.
And all this out-of-pocket expense is in addition to the money they take out of my paycheck to pay for this insurance that I can't actually use for anything.
Dr. Grundy, I see in one of your responses below that studies validate my experience that the those with private fee-for-service insurance are less likely to receive appropriate, evidence-based treatment.
And I couldn't even consider treatment for a catastrophic illness because after the $1500 deductible, my insurance only covers 80%. Of some things. Zero for other things.
So I used all these words to basically say that our health care system doesn't work and isn't going to anytime soon.
As you've seen, waiting to get care can be more costly. For lab work, ask your doctor what the tests are and call around to different labs. Some won't work with certain labs because they feel the results are unreliable, so ask about that, but do shop around. I found hospital labs (located conveniently near my doctor's office) charge double what a self-standing lab in my neighborhood costs.
If you can't do generic prescriptions to bring the price down, check WalMart--I find that's the cheapest. Costco has a break for the uninsured but not for those with deductibles. Also, consider using food and nutritional supplements to address underlying issues--this is a type of preventive medicine that can be very affordable. Acupuncture, too, is less expensive and often effective for many conditions, not just pain.
The poor actually get quite good corrective care even if they cannot pay - the same care that the wealthier patients get - although they do miss out on the preventative.
It is the in-betweeners that are in real trouble: first they loose their savings, then their house, then their credit rating - until they, too, are poor and so pay nothing. But the service they get is the same high-quality service throughout the process.
But you make an important point about drugs being prescribed for conditions that would be better addressed by lifestyle changes. But is it the underpaid pcp's job to call a person regularly to ask, "Are you exercising? Eating more whole grains? How's the stress management going? Did you take that meditation class?"
I think the system has to be designed around making it as easy as possible for a person to get preventive care of any type. True, a person with lifestyle/eating related high bp should stop eating junk, but I'd rather have her on blood pressure medications I pay into via my premiums than have her suffer a stroke I have to help pay for, kwim?
America has the best healthcare system in the world for the wealthy
It is only the poorest 90% who are worse off than in other OECD countries
Can you provide some statistics or other data about which countries, as well as the income levels of these people who come here for their care, and possibly even the type of treatment they're receiving?
I'd like to know more about this.
My sense is that it's a function of folks who want special procedures/treatment, don't want to have to wait for the procedure/treatment in their own country, and have the funds to pay for it.
Everything said in this article sounds good and logical, but I sense there are other aspects to this proposal that many would find objectionable if the whole thing - good and bad - from the patient's point of view, was completely described.
* Dignity and Respect. Health care practitioners listen to and honor patient and family perspectives and choices. Patient and family knowledge, values, beliefs and cultural backgrounds are incorporated into the planning and delivery of care.
* Information Sharing. Health care practitioners communicate and share complete and unbiased information with patients and families in ways that are affirming and useful. Patients and families receive timely, complete, and accurate information in order to effectively participate in care and decision-making.
* Participation. Patients and families are encouraged and supported in participating in care and decision-making at the level they choose.
* Collaboration. Patients and families are also included on an institution-wide basis. Health care leaders collaborate with patients and families in policy and program development, implementation, and evaluation; in health care facility design; and in professional education, as well as in the delivery of care.
This is the kind of care I want to buy