Friday, August 10, 2007

Public Trust, taking the High Road, more Knowledgeable Healthcare Consumers

Since this is my first ever blog, I wish it was one of the healthy stories I could be proud of, but it is not. I want to address several points that I believe are important in helping consumers be better buyers of health services. We want you, the consumer, to trust your hospital and doctor; but you need to do more of your own research and hold us accountable. The more you are involved, the better it is for all. Hospitals, doctors and insurance companies make it very difficult for you, the consumer, to have the same information we have on quality and out-of-pocket expenses and the real value of what you get for what you pay for. Sure, there are legal, antitrust, and lots of others reasons why…so with all that being said let me get down to the knitty gritty.

This is Susie’s* story. I will also be polite when I get to the doctors involved who are excellent physicians. Susie went to an appointment with her mother to see a specialist located off campus. Her mother is a resident in the nursing home attached to our hospital. After the visit, the nursing home contacted Susie to let her know the specialist had ordered an MRI and EEG at an offsite imaging center. Susie then contacted the doctor’s office to request that these tests be done at our hospital. Two of the individuals at the doctor’s office told Susie they could not write test orders for Alliance Community Hospital. Susie assured them that if they just sent her an order for the test, she could schedule it at the hospital. They again disagreed, but Susie persisted and indicated to them if it were written on a doctor’s script it was no different than a script for a prescription which could be filled at any drugstore chosen by a patient. So as long as this physician group was licensed to practice medicine in Ohio, Alliance Community Hospital would also accept the orders for the MRI and EEG. Susie told the office staff the reason she wanted them done at the hospital is because the nursing home is attached to the hospital and did not feel she should have to pay the extra expense of an ambulette ($50 round trip) versus a wheel chair ride down the hallway. In addition her mom gets confused when leaving the building and it takes time to get her reoriented.

The office finally returned the call and said they would fax the order for the MRI, but not for the EEG, because the doctor cannot read that test if it is done at the hospital. Susie then requested that they cancel the order for the EEG at the specialist’s office and she would contact her mother’s primary care physician’s office to order the EEG and then have the results forwarded to both her mom’s primary care physician and the specialist who wanted to do the EEG in his office. Susie added we need to find a better way to educate patients and their families.

A couple of final comments. Obviously, the physician specialist could read the test results done at the hospital, but would not get the facility fee for doing the procedure in his office or the professional reading fee. In addition, the patient would have another $50 ambulette fee.

A year or so ago I, the CEO, gave an exclusive reading contract for another service that impacted this group of specialists. They immediately dropped all privileges at the hospital. I only mention this because both we the hospital and this group of physicians want your business in areas we compete in. Many of my friends seek care from this specialty group and I support that. They are good docs.

The key here is when a patient or one of the 1200 colleagues or volunteers I work with request to have services here at the hospital, or for that matter anyone that prefers our service, it should be respected. Too many times over the past year I have personally called primary care physician offices on behalf of patients regarding this same issue. The specialist would often refer these patients to a surgeon in Canton where, in many cases the surgeon would request a repeat MRI at the hospital because the quality of the test results from the facility where the specialist had ordered the test was not adequate. I would hope that this group would start taking the high road and respect their patients’ requests.

Susie, you are right! We need more knowledgeable consumers. Hospitals and doctors must do a much better job of educating and disclosing all the facts of why we recommend where procedures are done, what is the overall quality and value of the service, and definitely consider the cost and service factors important to patients and their families, or we will certainly lose their trust.

Stan

*Susie's name has been changed for confidentiality reasons

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