Kameron Gifford, CPC
Medicine is practiced much different today than it was twenty years ago. The delivery of care has been altered and reshaped over and over again in an effort to continually comply with new regulations, changing technology, complicated reimbursement systems and increasing numbers of patients.
The development of technology has allowed us a greater understanding of the human body and better tools to diagnosis, treat and prevent disease. Revolutionary ideas such as employer sponsored health care and benefits for low income children have allowed us to extend health coverage to many more Americans. Standardized reimbursement codes have provided researchers the opportunity to study the prevalence of disease and track outcomes of treatment; and most recently we have seen alternative models of care aimed at improving outcomes (and costs) in high risk populations.
How has all of this innovation affected the consumer’s perception of health care and patient provider relationships? There is a growing population of insured Americans that choose not to access our healthcare system. There reason, whatever it may be, has become a barrier to them receiving primary and preventive services.
My aunt is one of these people. In the last twenty years she has sought medical attention only twice… both through the emergency for an acute injury. She will be 63 years old this year and has never had a mammogram or a colonoscopy; not even annual labs in over 25 years. Her decision was not pre-empted by her lack of access or knowledge. My aunt is an attorney who successfully fought to protect patient’s rights and increase accountability in the medical community. Her choice is founded in the dilution of the patient provider relationship and the non-existence of patient privacy. The decision to trade medical care for privacy is a personal one, one that no one can force her to change. She continues to pay her premiums, as she always has, so the deterrence of a tax penalty would not even apply. How do we engage these people?
I have to believe that there is an alternative system that can engage these individuals on their own terms. Perhaps, a one size fits all system shouldn’t be the only way.
I see a growing market developing for “patient directed” care. This idea is not new, but until recent advances in technology we were unable to assess a patient “remotely”. With this innovative technology we can now offer non-conventional solutions directly to the consumer. These disruptive tools will allow us to meet the individual needs of all consumers on their own terms.
If our ultimate goal in healthcare reform is to create a sustainable system, we must work with each individual population to create personal solutions.
So, how do we reach this population of patients that “distrust” the current system, and what type if any, would build enough trust to create access?
ERM is diligently working to create an integrated platform of primary care that can be delivered directly to the patient in a setting of their choice. This network of patient directed care will allow us to close gaps left by traditional systems; and provide “On Demand” care for less than $30 a visit.
On a recent visit, I had the opportunity to pitch this concept to my aunt just as I had hundreds before. But this time, her reaction was different…
After picking her up at the airport I noticed an infected mosquito bite on her left elbow. After the usual back and forth about her refusal to see a doctor, I asked if she would have been more willing with our new system. After determining the cost was $5 less than her copay and she was the gate keeper of her records – she was left without an excuse and to both of our surprise she said, Yes!”
The decision to seek, or not to seek, medical care is a private choice. Personal responsibility can’t be demanded or forced, even with punitive taxes. We must invest in whole system change that is flexible enough for every American. Awareness begins with education and education empowers healthier choices. Choices, after all is the ultimate behavior that we seek to improve if we are ever to create a valuable system.