I took a class this summer about the Administration of Healthcare Organizations. I wasn’t looking forward to it and was very nervous going into it. But it actually turned out to be a VERY interesting class. With respect to my own health issues, I learned a great deal. I also discovered a lot that I will be able to apply to my practice of veterinary medicine.
Part of what we did in that class was to journal each week about our studies. Since I spent time on my journal and not posting to my blog, I thought I would publish some of my class journals on the blog. I’m not sure it will mean anything to anyone except me, but I hope you find some jewels just like I did. Sorry the formatting is so funky…I’ll try to work on that.
INTRODUCTION TO HEALTHCARE
OK, I have to admit
that prior to this first week I was very nervous. The subject of human
healthcare is way outside of my expertise, even though I have been a chronic
consumer. It is interesting to hear healthcare referred to as an industry,
because it makes it seem so large and expansive and over-reaching. As a
veterinarian, I know I’m part of the animal health industry, but my goal is to
peel away all of the layers and bring vet care to a personal level in the exam
room. I think that is why my clients like me. I feel like I spend a lot of time
talking, but my goal is to ask the right questions and find the answers that
the clients often don’t know that they have. Good pet care begins with getting
knowledge and ends with giving knowledge back to the client. I like it when I
get the same kind of personal care from my doctors, so thinking in terms of an
‘industry’ is overwhelming and a little scary.
One of the most
interesting parts of the presentations this week was the John Stossel segment
on Whole Foods and their approach to purchasing services from health
practitioners. It makes a great deal of sense and would seem to be very
effective. But as a doctor, I have to confess I don’t know the prices of
procedures and services that my clinic offers. Size of patient and length of
procedure are just two variables that can affect cost. However, I do have my
staff print off estimates and I will go over them with the client. The other
issue that I have to consider, which I think may also have great relevance to
this topic, is that I have to be careful not to only offer services that I
think my clients can afford. It isn’t my place to make those decisions for
them. Offering plan ‘A’, ‘B’ & ‘C’ can help the client receive services
that benefit the patient and also stay in their budget. We’re seeing more people use Care Credit (a medical credit card) and various
forms of pet insurance. I really do recommend that clients have these tools
available; what many don’t realize is that the cost of veterinary care is
closer to what their own health care should be without medical insurance.
Perhaps that’s why I
don’t think ‘healthcare reform’ is a practical approach to addressing this
issue. Because the industry is so big and changing rapidly, you cannot just
whisk in and make sweeping and effective changes. I think compartmentalization
is the key; break the healthcare industry down into its various sections and
functions and work on them one at a time. I also think another key to efficient
healthcare is to keep the administration as close as possible to the consumer.
Too many layers of bureaucracy create waste and inefficiency. Think of the
restaurant owner who walks through his dining room full of customers; he can
get feedback on their favorite dishes, what they’d like to eat, and what isn’t
working (be it food, staff, environment, etc.). The restaurateur is in a much
better position then to address the important topics to improve his customers’
experiences. Ha, if only it were that easy!
I hate that this
topic has become so partisan and so political. It keeps people from coming up
with good solutions that are practical and efficient. And when things get
stalled out because everyone is so busy hammering away at their point of view,
real opportunities are missed. I’m really bothered by the term ‘equality’, and
I’m hoping to learn more in this class about how it is applied. I do think that
everyone should have equal opportunities for health care (and everything else),
but it is unreasonable to expect equal outcomes. So much can happen on that
journey from A to Z, and I believe that the direction of that journey must be
decided by the individual, not by a third party, and especially not by a government that can’t
even run itself well. I’m sounding more and more libertarian all of the time.
That is too funny.
I love the fact that
the history of public health was brought up. I love history. Here I wish we had
LESS compartmentalization. It seems that most people think that history is for
historians, but we can/should learn all there is about the background of our
professions, families, and politics. Why repeat someone else’s mistakes. Figure
out what worked and what didn’t. There is a lot of interesting knowledge out
there, much more applicable to today than most people realize. In my public
health area, there are diseases that are emerging much in the same way that
they emerged centuries ago. I think
there are some basic public health principles (like sanitation and quarantine)
that need to be ‘rediscovered’ as people have become so dependent upon
antibiotics and hospital care.