Lewis and Clark had nothing on today’s healthcare consumer. The labyrinth that is the modern U.S. healthcare system can be every bit as challenging and impenetrable as the early wilderness the intrepid explorers traversed.
Thank goodness for family physicians. It’s largely because of these dedicated servants that healthcare consumers have dependable, trustworthy guides to shepherd them safely through uncharted territories.
It’s for those reasons that we at Crossroads Hospice & Palliative Care pause to honor doctors for their courage and commitment this Doctors Day, March 30th.
The challenges posed by our massive healthcare system can seem bewildering to the average person. Just making sense of complicated medical options or dealing with a third-party insurer’s denial of a claim can be overwhelming. Further complicating the picture is the healthcare model itself, which skews toward endless diagnostic testing and a cure-at-all-costs approach regardless of how it may affect the patient’s quality of life.
To their credit, some doctors’ groups have recognized the symptoms of a sick healthcare model and are doing something about it:
Since its creation five years ago, a “Choosing Wisely” initiative sponsored by the American Board of Internal Medicine Foundation (ABIM) has brought together more than 80 medical society partners to educate clinicians and published over 500 recommendations about overused tests and treatments.
In September, 2017, an editorial in the Journal of the American College of Cardiology commended the authors of a research study demonstrating how palliative care can help heart failure patients in terms of quality of life, depression, anxiety, and spiritual well-being.
A Holistic Perspective
In fact, the growth of palliative care and hospice is one of the most significant movements in recent years. While it’s an area of care that is often overlooked or misunderstood, for family doctors and their patients, the positive effects can be life-changing.
Palliative and hospice specialists are trained to view their patients holistically and emphasize quality of life – not just look for the next symptom to cure. Their approach recognizes patients often are dealing with emotional and spiritual issues that must be addressed with as much urgency as medical issues.
Doctor-patient communication is key, ensuring that needs, fears and priorities of patient and family all get sufficient consideration. It’s an approach that supports and complements the traditional role of the family doctor.
Focus on the Patient
Not long ago, the primary care doctor of a patient with chronic obstructive pulmonary disease (COPD), asked Crossroads to help coordinate a treatment program. The patient had been in and out of the hospital repeatedly over the course of two months. In addition to experiencing breathing discomfort, the recurrent readmissions caused great anxiety for the patient. Plus, the hospital treatments were very expensive. With the average stay costing about $37,000 per visit, the patient’s medical treatment bill for those two months was over $150,000.
Crossroads palliative care specialists determined that while the patient had received her COPD medication when she was discharged, she did not have a nebulizer in her home. A nebulizer is essential because it administers the medication in the form of a mist inhaled into the patient’s lungs.
Coordination is Key
Crossroads helped coordinate among hospital staff, a durable medical equipment (nebulizer) provider and a nurse practitioner to show the patient how to use the nebulizer. As a result, the patient was treated at home where she was more comfortable, had less anxiety and received nebulizer treatments at a fraction of the cost of hospital treatments.
In other instances, Crossroads palliative care specialists have worked closely with primary care doctors to treat chemotherapy patients exhibiting intractable nausea and vomiting. We also work with cardiologists on treatment programs for patients to minimize repeated and costly in-hospital care. Often heart patients can be treated at home, in a more comfortable, less expensive setting.
Family physicians understand the need for efficient coordination of medical services. But even for them, the path can be winding and uncertain. Palliative and hospice care specialists can support and enhance their efforts, helping to set a course that leads to a more patient-focused effort and better care.
Healthcare, after all, should be a team effort that empowers doctors to do what they do best – care for their patients to the best of their abilities.
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